Provider Demographics
NPI:1912964800
Name:SCHAFHAUSER, MICHAEL WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:SCHAFHAUSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 7TH ST E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-4914
Mailing Address - Country:US
Mailing Address - Phone:651-222-1201
Mailing Address - Fax:651-227-6523
Practice Address - Street 1:30 7TH ST E
Practice Address - Street 2:SUITE 101
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-4914
Practice Address - Country:US
Practice Address - Phone:651-222-1201
Practice Address - Fax:651-227-6523
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND87831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice