Dr. Roman Grant, DDS
Dentist, General Practice in Rockwall, TX. Individual provider (NPI-1).
NPI number1164039293
StatusActive
Last updated in NPPESJul 11, 2023
Details
- NPI
- 1164039293
- Entity type
- Individual (NPI-1)
- Name
- Dr. Roman Grant
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 23, 2020
- Certification date
- Jul 11, 2023
- Last updated
- Jul 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 36661 | TX | Yes |
| 122300000X | Dentist | 36661 | TX |
Practice location
703 S Goliad StRockwall, TX 75087-3935
Phone 972-771-9131
Mailing address
2616 Tulip DrRichardson, TX 75082-4244
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