Provider Demographics
NPI:1831780436
Name:DANIEL SCHAEFFLER DMD LLC
Entity type:Organization
Organization Name:DANIEL SCHAEFFLER DMD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-668-9920
Mailing Address - Street 1:218 SHARROW VALE RD
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1926
Mailing Address - Country:US
Mailing Address - Phone:609-668-9920
Mailing Address - Fax:
Practice Address - Street 1:8016 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-3056
Practice Address - Country:US
Practice Address - Phone:609-668-9920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1093062002OtherNPI
PADS039106OtherPA DENTAL LICENSE