MEDICARE: TMG DENTAL HEALTH FOUNDATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	2901015910	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881998029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TMG DENTAL HEALTH FOUNDATION, INC.

Provider Business Mailing Address
First Line	:	30835 W 10 MILE RD
Second Line	:	SUITE 5010
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2607
Country	:	US
Telephone Number	:	313-363-6004
Fax Number	:	248-542-3243

Provider Business Practice Location Address
First Line	:	30835 W 10 MILE RD
Second Line	:	SUITE 5010
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2607
Country	:	US
Telephone Number	:	313-363-6004
Fax Number	:	248-542-3243

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JAMES ARTHUR MURRAY
Credential	:	DDS
Telephone Number	:	313-363-6004

Provider Enumeration Date	:	01/03/2011
Last Update Date	:	10/23/2013

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