Individual
EDWIN FRED GRIMES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
101 W CREEK ST, FREDERICKSBURG, TX 78624-3730
(830) 990-1178
Mailing address
101 W CREEK ST, FREDERICKSBURG, TX 78624-3730
(830) 990-1178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08430
TX
Other
Enumeration date
04/10/2007
Last updated
07/09/2007
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