Provider Demographics
NPI:1720044423
Name:SHAFFER, PATRICK B (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:B
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10537 BROWN FOX TRL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-9204
Mailing Address - Country:US
Mailing Address - Phone:520-850-8364
Mailing Address - Fax:
Practice Address - Street 1:10537 BROWN FOX TRL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-9204
Practice Address - Country:US
Practice Address - Phone:520-850-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002054691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice