Shafer, David
Shafer, David is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-0001. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Shafer, David can be contacted via phone (860) 679-3300.Contact Information
Primary practice address
263 Farmington Ave
Farmington CT 06030-0001
Phone: (860) 679-3300
Fax: (860) 679-1099
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 007624 | Connecticut |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 007624 | Connecticut |
Profile Details
| NPI number | 1528065992 |
|---|---|
| LBN Legal business name | Shafer, David |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | May 12th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528065992 | NPPES |
| Connecticut | MEDICAID | 002076249 |
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