Provider Demographics
NPI:1053209288
Name:GREWAL, ALAMPARTAP (DDS)
Entity type:Individual
Prefix:
First Name:ALAMPARTAP
Middle Name:
Last Name:GREWAL
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 1:2204 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:IN
Mailing Address - Zip Code:46001-8059
Mailing Address - Country:US
Mailing Address - Phone:765-724-7729
Mailing Address - Fax:
Practice Address - Street 1:2204 S PARK AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:IN
Practice Address - Zip Code:46001-8059
Practice Address - Country:US
Practice Address - Phone:765-724-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014811A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist