Granger Dental Group, Llc | |
6910 N Main St Bldg 1, Unit 58 Granger IN 46530-9680 | |
(574) 277-4235 | |
Not Available |
Full Name | Granger Dental Group, Llc |
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Speciality | Dentist - General Practice |
Location | 6910 N Main St, Granger, Indiana |
Authorized Official Name and Position | Joseph E Hickey (DENTIST OWNER) |
Authorized Official Contact | 5742747778 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Granger Dental Group, Llc 6910 N Main St Bldg 1, Unit 58 Granger IN 46530-9680 Ph: (574) 277-4235 | Granger Dental Group, Llc 6910 N Main St Bldg 1, Unit 58 Granger IN 46530-9680 Ph: (574) 277-4235 |
NPI Number | 1245688282 |
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Provider Enumeration Date | 06/01/2016 |
Last Update Date | 06/01/2016 |
Identifier | Type | State | Issuer |
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1245688282 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 12011040A (Indiana) | Primary |
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