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Organization
794 KELLER PARKWAY KELLER SERVICES PLLC
Active
Organization
794 KELLER PARKWAY KELLER SERVICES PLLC
Active
Other names
Keller Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
PETER C GRUMBOS DDS (OWNER)
(817) 431-1596
Entity
Organization
Contact information
Practice address
794 KELLER PKWY, KELLER, TX 76248-2488
(817) 431-1596
(817) 755-1719
Mailing address
794 KELLER PKWY, KELLER, TX 76248-2488
(817) 431-1596
(817) 755-1719
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18458
DENTAL LICENSE
TX
Enumeration date
01/07/2019
Last updated
01/07/2019
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