Provider Demographics
NPI:1952382368
Name:STANLEY SCHAEFFER DDS INC
Entity Type:Organization
Organization Name:STANLEY SCHAEFFER DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-747-4411
Mailing Address - Street 1:210 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4217
Mailing Address - Country:US
Mailing Address - Phone:760-747-4411
Mailing Address - Fax:760-747-6392
Practice Address - Street 1:210 S BROADWAY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4217
Practice Address - Country:US
Practice Address - Phone:760-747-4411
Practice Address - Fax:760-747-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA204581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty