Provider Demographics
NPI:1821181660
Name:SCHAFFER, SCOTT BARRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BARRY
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1811
Mailing Address - Country:US
Mailing Address - Phone:732-382-2715
Mailing Address - Fax:732-382-8695
Practice Address - Street 1:77 VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1811
Practice Address - Country:US
Practice Address - Phone:732-382-2715
Practice Address - Fax:732-382-8695
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI159271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice