Provider Demographics
NPI:1770775454
Name:CINDY L. DANCHAK DC
Entity type:Organization
Organization Name:CINDY L. DANCHAK DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DANCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-322-4300
Mailing Address - Street 1:625 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04849-4217
Mailing Address - Country:US
Mailing Address - Phone:207-322-4300
Mailing Address - Fax:
Practice Address - Street 1:13230 WINDYGATE LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-2240
Practice Address - Country:US
Practice Address - Phone:314-412-8233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR 952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM98943Medicare UPIN