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Organization
TY SHAFER DDS PA
Active
Organization
TY SHAFER DDS PA
Active
Other names
Southlake Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TY D SHAFER D.D.S. (OWNER)
(817) 416-2228
Entity
Organization
Contact information
Practice address
2000 E HIGHWAY 114, SOUTHLAKE, TX 76092-6514
(817) 416-2228
(817) 421-0408
Mailing address
2000 E HIGHWAY 114, SOUTHLAKE, TX 76092-6514
(817) 416-2228
(817) 421-0408
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21301
TX
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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