Ty Shafer DDS PA

NPI #1457502429 in Southlake, Texas

Provider Information

NPI Number: 1457502429
Entity Type: Organization
Organization Name: Ty Shafer DDS PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 8, 2008
Last Updated: Oct 8, 2008

Practice Location

Address: 2000 E HIGHWAY 114
City: Southlake
State: Texas
ZIP Code: 76092-6514
Phone: (817) 416-2228

Authorized Official

Name: DR. TY D 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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