Provider Demographics
NPI:1740376417
Name:SCHAEFERLE, TAMMI JO (DDS)
Entity type:Individual
Prefix:DR
First Name:TAMMI
Middle Name:JO
Last Name:SCHAEFERLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4147 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3001
Mailing Address - Country:US
Mailing Address - Phone:614-263-0300
Mailing Address - Fax:614-263-7914
Practice Address - Street 1:4147 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3001
Practice Address - Country:US
Practice Address - Phone:614-263-0300
Practice Address - Fax:614-263-7914
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH210071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice