Provider Demographics
NPI:1093062002
Name:SCHAEFFLER, DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:SCHAEFFLER
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 1:8016 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3056
Mailing Address - Country:US
Mailing Address - Phone:215-482-8600
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:215-482-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02513400122300000X
PADS039106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist