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1003830597
ROGER GLEN GRIMBALL
SULPHUR, LA
NPI
1003830597
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: LA 5330)
Enumeration Date
2006-07-27
Last Update Date
2007-07-08
Business Address
Dr. ROGER GLEN GRIMBALL D.D.S.
910 BEGLIS PKWY
SULPHUR, LA 70663-5102
Phone number: 337-625-2212
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Mailing Address
Dr. ROGER GLEN GRIMBALL D.D.S.
910 BEGLIS PKWY
SULPHUR, LA 70663-5102
Phone number: 337-625-2212
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