Provider Demographics
NPI:1265791909
Name:SCHAPPER, MATTHEW (DMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:SCHAPPER
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 1:90974 S WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:COBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97408-9206
Mailing Address - Country:US
Mailing Address - Phone:801-750-3685
Mailing Address - Fax:
Practice Address - Street 1:869 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4307
Practice Address - Country:US
Practice Address - Phone:801-750-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD98851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice