Provider Demographics
NPI:1760781116
Name:SCHAFFER, CAROL GAIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:GAIL
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:GAIL
Other - Last Name:KIRSCHENBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:436 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28646
Mailing Address - Country:US
Mailing Address - Phone:828-737-7722
Mailing Address - Fax:828-737-7931
Practice Address - Street 1:436 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LINVILLE
Practice Address - State:NC
Practice Address - Zip Code:28646
Practice Address - Country:US
Practice Address - Phone:828-737-7722
Practice Address - Fax:828-737-7931
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC56311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice