Provider Demographics
NPI:1497161988
Name:GREWAL, SUKHMAN KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUKHMAN
Middle Name:KAUR
Last Name:GREWAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 FM 423 APT 2308
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7148
Mailing Address - Country:US
Mailing Address - Phone:361-658-6902
Mailing Address - Fax:
Practice Address - Street 1:5050 FM 423 APT 2308
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7148
Practice Address - Country:US
Practice Address - Phone:361-658-6902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist