Organization
GROESBECK FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM ROBERT JENNINGS JR. DDS (OWNER)
(940) 206-8956
Entity
Organization
Contact information
Practice address
902 W YEAGUA ST, GROESBECK, TX 76642-3526
(254) 729-8400
Mailing address
17480 DALLAS PKWY STE 213, DALLAS, TX 75287-7304
(972) 248-1221
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902829070
—
TX
Enumeration date
04/19/2019
Last updated
04/19/2019
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