Provider Demographics
NPI:1275680050
Name:DANCHAK, GARY
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:DANCHAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16750 MOUNT ROSE HWY
Mailing Address - Street 2:STE. 105
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8774
Mailing Address - Country:US
Mailing Address - Phone:775-849-9800
Mailing Address - Fax:
Practice Address - Street 1:16750 MOUNT ROSE HWY
Practice Address - Street 2:STE. 105
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8774
Practice Address - Country:US
Practice Address - Phone:775-849-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1010174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist