Provider Demographics
NPI:1346673779
Name:ANDREW J DEAK DMD & ASSOCIATES INC
Entity Type:Organization
Organization Name:ANDREW J DEAK DMD & ASSOCIATES INC
Other - Org Name:KAMM'S CORNERS DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:216-251-8787
Mailing Address - Street 1:3730 ROCKY RIVER DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-4044
Mailing Address - Country:US
Mailing Address - Phone:216-251-8787
Mailing Address - Fax:216-251-7370
Practice Address - Street 1:3730 ROCKY RIVER DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-4044
Practice Address - Country:US
Practice Address - Phone:216-251-8787
Practice Address - Fax:216-251-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental