Shafer, Robert William

Shafer, Robert William is an sole proprietor health care provider with primary practice located at 2902 Crossing Ct Suite A, Champaign IL 61822-6175. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Shafer, Robert William can be contacted via phone (217) 356-9595.

Contact Information

Primary practice address
2902 Crossing Ct Suite A Champaign IL 61822-6175
Phone: (217) 356-9595
Fax: (217) 356-6425
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 19022993 Illinois

Profile Details

NPI number 1508960170
LBN Legal business name Shafer, Robert William
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2006
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508960170 NPPES
Illinois Other 19022993 ORTHODONTIC LICENSE

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