Provider Demographics
NPI:1003028531
Name:DR. DANIEL J. FEMIAK D.D.S., P.C.
Entity Type:Organization
Organization Name:DR. DANIEL J. FEMIAK D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FEMIAK
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:219-793-9710
Mailing Address - Street 1:8687 CONNECTICUT STREET STE. E.
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5549
Mailing Address - Country:US
Mailing Address - Phone:219-793-9710
Mailing Address - Fax:219-793-9549
Practice Address - Street 1:8687 CONNECTICUT STREET STE. E.
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5549
Practice Address - Country:US
Practice Address - Phone:219-793-9710
Practice Address - Fax:219-793-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ12008970261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental