# 794 KELLER PARKWAY KELLER SERVICES PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Keller Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891268421
- **Authorized official:** PETER C GRUMBOS DDS (OWNER)
- **Authorized official phone:** (817) 431-1596

## Contact information

- **Practice address:** 794 KELLER PKWY, KELLER, TX 76248-2488
- **Practice address phone:** (817) 431-1596
- **Practice address fax:** (817) 755-1719
- **Mailing address:** 794 KELLER PKWY, KELLER, TX 76248-2488
- **Mailing address phone:** (817) 431-1596
- **Mailing address fax:** (817) 755-1719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2019
- **Last updated:** 01/07/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 18458 | DENTAL LICENSE | TX |