Provider Demographics
NPI:1871163717
Name:SHAFER, ANDREW FRANCIS (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:FRANCIS
Last Name:SHAFER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1567 DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3349
Mailing Address - Country:US
Mailing Address - Phone:610-279-1811
Mailing Address - Fax:610-279-6977
Practice Address - Street 1:1567 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3349
Practice Address - Country:US
Practice Address - Phone:610-279-1811
Practice Address - Fax:610-279-6977
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO432351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice