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General NPI Number Information
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NPI Number | 1558570531
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Entity Type | Individual
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Provider Name | ROBERT HUNTER GRIMES D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 8901 MILWAUKEE AVENUE
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City | LUBBOCK
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State | TX
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Zip | 79424-1931
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Country | US
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Telephone | 806-798-3384
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Fax | 806-794-0504
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Provider Business Mailing Address
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Address Line | 8901 MILWAUKEE AVENUE
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City | LUBBOCK
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State | TX
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Zip | 79424-1931
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Country | US
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Telephone | 806-798-3384
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Fax | 806-794-0504
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16349
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License Number State | TX
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