# ADVANCE DENTURES OF MICHIANA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720658040
- **Authorized official:** CHRISTINA LEMELIN (OFFICE MANAGER)
- **Authorized official phone:** (574) 855-1364

## Contact information

- **Practice address:** 311 FLORENCE AVE, GRANGER, IN 46530-8049
- **Practice address phone:** (574) 855-1364
- **Practice address fax:** (574) 314-5238
- **Mailing address:** 311 FLORENCE AVE, GRANGER, IN 46530-8049
- **Mailing address phone:** (574) 855-1364
- **Mailing address fax:** (574) 314-5238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2021
- **Last updated:** 06/29/2021