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General NPI Number Information
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NPI Number | 1003028531
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Entity Type | Organization
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Legal Business Name | DR. DANIEL J. FEMIAK D.D.S., P.C.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8687 CONNECTICUT STREET STE. E.
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5549
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Country | US
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Telephone | 219-793-9710
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Fax | 219-793-9549
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Provider Business Mailing Address
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Address Line | 8687 CONNECTICUT STREET STE. E.
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5549
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Country | US
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Telephone | 219-793-9710
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Fax | 219-793-9549
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DANIEL JAMES FEMIAK III
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Credential | D.D.S., P.C.
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Telephone | 219-793-9710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | IN12008970
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License Number State | IN
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