Provider Demographics
NPI:1578544193
Name:SHAPTER, DAVID E (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:SHAPTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:128 W 12TH ST
Mailing Address - Street 2:STANDARD SQUARE, SUITE 300
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1725
Mailing Address - Country:US
Mailing Address - Phone:814-868-8673
Mailing Address - Fax:814-866-0232
Practice Address - Street 1:128 W 12TH ST
Practice Address - Street 2:STANDARD SQUARE, SUITE 300
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1725
Practice Address - Country:US
Practice Address - Phone:814-868-8673
Practice Address - Fax:814-866-0232
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023362L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014341770005Medicaid