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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