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Organization
TY SHAFER DDS PA
Active
Organization
TY SHAFER DDS PA
Active
Other names
Shafer Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TY SHAFER D.D.S (OWNER)
(817) 416-2228
Entity
Organization
Contact information
Practice address
311 W. SOUTHLAKE BLVD., SUITE 100, SOUTHLAKE, TX 76092
(817) 416-2228
(817) 421-0408
Mailing address
311 W. SOUTHLAKE BLVD., SUITE 100, SOUTHLAKE, TX 76092
(817) 416-2228
(817) 421-0408
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21301
TX
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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