Organization
MICHAEL SHAFER DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KENT SHAFER DDS (DENTIST/OWNER)
(802) 674-5999
Entity
Organization
Contact information
Practice address
2419 GOULDEN RIDGE RD, SPRINGFIELD, VT 05156-9510
(802) 674-5596
Mailing address
2419 GOULDEN RIDGE RD, SPRINGFIELD, VT 05156-9510
(802) 674-5596
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
692
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001952
—
VT
Enumeration date
08/30/2006
Last updated
04/12/2008
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