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Dr. Roger Glen Grimball JR., DDS
Pediatric Dentist in Sulphur, Louisiana
NPI 1003830597

Roger Glen Grimball JR. is a Pediatric Dentist based in Sulphur, LA and is specialized in Pediatric Dentistry. Roger Glen Grimball JR. practices in Sulphur, LA and has the professional credentials of DDS. The NPI Number for Roger Glen Grimball JR. is 1003830597 and holds a License No. 5330 (Louisiana).

The current practice location address for Roger Glen Grimball JR. is 910 Beglis Pkwy, Sulphur, LA and can be reached out via phone at 337-625-2212 and via fax at 337-625-3231.

Location: 910 Beglis Pkwy, Sulphur, LA, 70663-5102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003830597
Provider Name
Roger Glen Grimball JR.
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
910 Beglis Pkwy, Sulphur, LA, 70663-5102
Phone Number
337-625-2212
Fax Number
337-625-3231
Provider Enumeration Date
07/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1853305 05 LA
institution
Provider Business Practice Location Address Details
Address
910 Beglis Pkwy
City
Sulphur
State
Louisiana
Zip
70663-5102
Phone Number
337-625-2212
Fax Number
337-625-3231
person
Provider Business Mailing Address Details
Address
910 Beglis Pkwy
City
Sulphur
State
Louisiana
Zip
70663-5102
Phone Number
337-625-2212
Fax Number
337-625-3231
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
5330 (Louisiana)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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