| Indiana Tmj Treatment Center | |
|
210 East Water Street Pendleton IN 46064-0206 | |
| (765) 778-3332 | |
| (765) 778-4860 |
| Full Name | Indiana Tmj Treatment Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 210 East Water Street, Pendleton, Indiana |
| Authorized Official Name and Position | Kenneth Lau (DOCTOR) |
| Authorized Official Contact | 7657783332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana Tmj Treatment Center 210 East Water Street P.o. Box 206 Pendleton IN 46064-0206 Ph: (765) 778-3332 | Indiana Tmj Treatment Center 210 East Water Street Pendleton IN 46064-0206 Ph: (765) 778-3332 |
| NPI Number | 1912955832 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 05/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912955832 | NPI | - | NPPES |
| 000000196290 | Other | IN | BLUE CROSS AND BLUE SHIEL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7161 (Indiana) | Primary |
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