| NPI | 1821662297 |
|---|---|
| Doing Business As | GRIMBALL PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ROGER GLEN GRIMBALL Dentist 337-625-2212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-07-28 |