794 Keller Parkway Keller Services PLLC
Dentist in Keller, TX. Organization (NPI-2).
NPI number1891268421
StatusActive
Last updated in NPPESJan 7, 2019
Details
- NPI
- 1891268421
- Entity type
- Organization (NPI-2)
- Legal business name
- 794 Keller Parkway Keller Services PLLC
- Organization subpart
- No
- Enumeration date
- Jan 7, 2019
- Last updated
- Jan 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Keller Family Dental (Doing Business As)
Practice location
794 Keller PkwyKeller, TX 76248-2488
Phone 817-431-1596 · Fax 817-755-1719
Mailing address
794 Keller PkwyKeller, TX 76248-2488
Phone 817-431-1596 · Fax 817-755-1719
Authorized official
Peter C Grumbos
Owner
8174311596
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