| NPI | 1720777840 |
|---|---|
| Doing Business As | TMJ AMD |
| Entity Type | Organization |
| Authorized Contact | NICOLE ROUSCULP Director Of Operations 574-968-5166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-04 |