Provider Demographics
NPI:1649502113
Name:DANCHIK, MICHAEL CORINE FUENTES (LAC, DIPL OM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CORINE FUENTES
Last Name:DANCHIK
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 ROBINSON WAY
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-5458
Mailing Address - Country:US
Mailing Address - Phone:720-251-3989
Mailing Address - Fax:
Practice Address - Street 1:12330 W 58TH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1243
Practice Address - Country:US
Practice Address - Phone:720-251-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1457171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist