Provider Demographics
NPI:1184099236
Name:SCHAEFER, PRISCILA (DDS)
Entity type:Individual
Prefix:DR
First Name:PRISCILA
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 WINDSONG TRL
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4453
Mailing Address - Country:US
Mailing Address - Phone:734-717-7968
Mailing Address - Fax:
Practice Address - Street 1:2100 ROSS AVE
Practice Address - Street 2:STE 960
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-2739
Practice Address - Country:US
Practice Address - Phone:214-999-0110
Practice Address - Fax:214-999-0114
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist