Provider Demographics
NPI:1558570531
Name:GRIMES, ROBERT HUNTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HUNTER
Last Name:GRIMES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 MILWAUKEE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1931
Mailing Address - Country:US
Mailing Address - Phone:806-798-3384
Mailing Address - Fax:806-794-0504
Practice Address - Street 1:8901 MILWAUKEE AVENUE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-1931
Practice Address - Country:US
Practice Address - Phone:806-798-3384
Practice Address - Fax:806-794-0504
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX163491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice