Ty Shafer DDS PA

NPI #1316229271 in Southlake, Texas

Provider Information

NPI Number: 1316229271
Entity Type: Organization
Organization Name: Ty Shafer DDS PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 15, 2011
Last Updated: Sep 15, 2011

Practice Location

Address: 311 W. SOUTHLAKE BLVD.
Address 2: SUITE 100
City: Southlake
State: Texas
ZIP Code: 76092
Phone: (817) 416-2228

Authorized Official

Name: DR. TY SHAFER, D.D.S
Title: OWNER
Phone: (817) 416-2228

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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