Provider Demographics
NPI:1982613758
Name:SCHAEFER, ROBERT BRUCE (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRUCE
Last Name:SCHAEFER
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 1:13641 JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:NEW FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:17349-8567
Mailing Address - Country:US
Mailing Address - Phone:717-235-7299
Mailing Address - Fax:
Practice Address - Street 1:2159 WHITE ST
Practice Address - Street 2:SUITE 16
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-4943
Practice Address - Country:US
Practice Address - Phone:717-846-1177
Practice Address - Fax:717-699-1113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023028-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice