Organization
ROGER GLEN GRIMBALL JR. D.D.S. LLC
Active
Other names
Grimball Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER GLEN GRIMBALL JR. (DENTIST)
(337) 625-2212
Entity
Organization
Contact information
Practice address
1570 MAPLEWOOD DR, SULPHUR, LA 70663-5643
(337) 625-2212
(337) 625-3231
Mailing address
1570 MAPLEWOOD DR, SULPHUR, LA 70663-5643
(337) 625-2212
(331) 625-3231
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
07/28/2021
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