MEDICARE: DR. ROBERT HUNTER GRIMES D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16349	TX

General Provider Information

NPI Number	:	1558570531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HUNTER GRIMES D.D.S.

Provider Business Mailing Address
First Line	:	8901 MILWAUKEE AVENUE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-1931
Country	:	US
Telephone Number	:	806-798-3384
Fax Number	:	806-794-0504

Provider Business Practice Location Address
First Line	:	8901 MILWAUKEE AVENUE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-1931
Country	:	US
Telephone Number	:	806-798-3384
Fax Number	:	806-794-0504

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	03/24/2021

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