Individual
DAVID SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-3300
(860) 679-1099
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
007624
CT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
007624
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002076249
—
CT
Enumeration date
06/30/2005
Last updated
05/12/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us