Provider Demographics
NPI:1881998029
Name:TMG DENTAL HEALTH FOUNDATION, INC.
Entity type:Organization
Organization Name:TMG DENTAL HEALTH FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-363-6004
Mailing Address - Street 1:30835 W 10 MILE RD
Mailing Address - Street 2:SUITE 5010
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2607
Mailing Address - Country:US
Mailing Address - Phone:313-363-6004
Mailing Address - Fax:248-542-3243
Practice Address - Street 1:30835 W 10 MILE RD
Practice Address - Street 2:SUITE 5010
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2607
Practice Address - Country:US
Practice Address - Phone:313-363-6004
Practice Address - Fax:248-542-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010159101223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI273182721Medicaid