| Tmj Amd | |
|
7221 N Fir Rd Granger IN 46530 | |
| (574) 968-5166 | |
| (877) 317-3186 |
| Full Name | Tmj Amd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7221 N Fir Rd, Granger, Indiana |
| Authorized Official Name and Position | Nicole Rousculp (DIRECTOR OF BUSINESS OPERATIONS) |
| Authorized Official Contact | 5749685166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tmj Amd 7221 Fir Rd Granger IN 46530-0078 Ph: (574) 968-5166 | Tmj Amd 7221 N Fir Rd Granger IN 46530 Ph: (574) 968-5166 |
| NPI Number | 1720777840 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 09/16/2026 |
| Certification Date | 09/16/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720777840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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