Organization
GRANGER FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JOHN ANGLEMIRE D.D.S. (OWNER / PRESIDENT)
(574) 277-5406
Entity
Organization
Contact information
Practice address
12545 ADAMS RD, GRANGER, IN 46530-9226
(574) 277-5406
(574) 277-5467
Mailing address
12545 ADAMS RD, GRANGER, IN 46530-9226
(574) 277-5406
(574) 277-5467
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007958B
IN
1223G0001X
General Practice Dentistry
12009209B
IN
Other
Enumeration date
09/13/2006
Last updated
09/14/2020
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