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Organization
LUM KIDS, LLC
Active
Organization
LUM KIDS, LLC
Active
Other names
TMJ AMD
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ROUSCULP (DIRECTOR OF BUSINESS OPERATIONS)
(574) 968-5166
Entity
Organization
Contact information
Practice address
7221 N FIR RD, GRANGER, IN 46530
(574) 968-5166
(877) 317-3186
Mailing address
7221 FIR RD, GRANGER, IN 46530-0078
(574) 968-5166
(877) 317-3186
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
09/16/2026
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