Provider Demographics
NPI:1013935030
Name:SCHAEFER, ABBIE T (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:T
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:ABBIE
Other - Middle Name:SCHAEFER
Other - Last Name:HORKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:3100 E EISENHOWER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-5205
Mailing Address - Country:US
Mailing Address - Phone:734-971-3368
Mailing Address - Fax:734-971-3979
Practice Address - Street 1:3100 E EISENHOWER PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-5205
Practice Address - Country:US
Practice Address - Phone:734-971-3368
Practice Address - Fax:734-971-3979
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI180961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4428137Medicaid