| Robert W Shafer Dds Ltd | |
|
2902 Crossing Ct Suite A Champaign IL 61822-6175 | |
| (217) 356-9595 | |
| (217) 356-6425 |
| Full Name | Robert W Shafer Dds Ltd |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2902 Crossing Ct, Champaign, Illinois |
| Authorized Official Name and Position | Robert William Shafer (ORTHODONTIST/OWNER) |
| Authorized Official Contact | 2173569595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert W Shafer Dds Ltd 2902 Crossing Ct Suite A Champaign IL 61822-6175 Ph: (217) 356-9595 | Robert W Shafer Dds Ltd 2902 Crossing Ct Suite A Champaign IL 61822-6175 Ph: (217) 356-9595 |
| NPI Number | 1184728768 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184728768 | NPI | - | NPPES |
| 19022993 | Other | IL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 19022993 (Illinois) | Primary |
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