Provider Demographics
NPI:1255814885
Name:THE DANCZAK DENTAL GROUP INC
Entity type:Organization
Organization Name:THE DANCZAK DENTAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DANCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:216-280-1600
Mailing Address - Street 1:8103 SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1772
Mailing Address - Country:US
Mailing Address - Phone:216-392-8986
Mailing Address - Fax:
Practice Address - Street 1:7083 PEARL RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4940
Practice Address - Country:US
Practice Address - Phone:440-888-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty