| Granger Family Dentistry, Pc | |
|
12545 Adams Rd Granger IN 46530-9226 | |
| (574) 277-5406 | |
| (574) 277-5467 |
| Full Name | Granger Family Dentistry, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12545 Adams Rd, Granger, Indiana |
| Authorized Official Name and Position | Thomas John Anglemire (OWNER / PRESIDENT) |
| Authorized Official Contact | 5742775406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Family Dentistry, Pc 12545 Adams Rd Granger IN 46530-9226 Ph: (574) 277-5406 | Granger Family Dentistry, Pc 12545 Adams Rd Granger IN 46530-9226 Ph: (574) 277-5406 |
| NPI Number | 1619072147 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 09/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619072147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12007958B (Indiana) | Primary |
| 1223G0001X | Dentist - General Practice | 12009209B (Indiana) | Secondary |
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