Provider Demographics
NPI:1861158958
Name:TJM DENTAL LLC
Entity type:Organization
Organization Name:TJM DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSCHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-372-5000
Mailing Address - Street 1:820 N SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-1685
Mailing Address - Country:US
Mailing Address - Phone:608-372-5000
Mailing Address - Fax:
Practice Address - Street 1:820 N SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1685
Practice Address - Country:US
Practice Address - Phone:608-372-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty