Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ROGER GLEN GRIMBALL JR., D.D.S.
Active Sole ProprietorDR. ROGER GLEN GRIMBALL JR., D.D.S. is a Pediatric Dentistry healthcare provider located in SULPHUR, Louisiana. NPI 1003830597 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · SULPHUR, LA
Registration Details
- NPI Number
- 1003830597
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 27, 2006 (20.079568498916 yrs)
- Last Updated
- Jul 8, 2007
- License
-
5330 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
910 BEGLIS PKWYSULPHUR, LA, 706635102Browse LA providers · Browse ZIP 70663
- Phone
- 3376252212
- Fax
- 3376253231
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.