| Grill Repair, Pa | |
|
708 Paluxy Rd Ste B Granbury TX 76048-2396 | |
| (817) 573-4600 | |
| Not Available |
| Full Name | Grill Repair, Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 708 Paluxy Rd Ste B, Granbury, Texas |
| Authorized Official Name and Position | Bryan Elvebak (OWNER) |
| Authorized Official Contact | 8175734600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grill Repair, Pa 708 Paluxy Rd Ste B Granbury TX 76048-2396 Ph: (817) 573-4600 | Grill Repair, Pa 708 Paluxy Rd Ste B Granbury TX 76048-2396 Ph: (817) 573-4600 |
| NPI Number | 1679871354 |
|---|---|
| Provider Enumeration Date | 03/04/2011 |
| Last Update Date | 03/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679871354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 20522 (Texas) | Primary |
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