Provider Demographics
NPI:1013108133
Name:JOHN S JORCZAK & DANIEL E SAKEL PTR
Entity Type:Organization
Organization Name:JOHN S JORCZAK & DANIEL E SAKEL PTR
Other - Org Name:DENTAL CARE OF LAFAYETTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SAKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-447-0959
Mailing Address - Street 1:38 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-3004
Mailing Address - Country:US
Mailing Address - Phone:765-447-0959
Mailing Address - Fax:765-447-0796
Practice Address - Street 1:38 N 23RD ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-3004
Practice Address - Country:US
Practice Address - Phone:765-447-0959
Practice Address - Fax:765-447-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009265A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty