Provider Demographics
NPI:1710388368
Name:UPPAL DENTAL GROUP, INC
Entity Type:Organization
Organization Name:UPPAL DENTAL GROUP, INC
Other - Org Name:APEX IMPLANT CENTER & DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SAPNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-262-0300
Mailing Address - Street 1:360 S GLENDORA AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:360 S GLENDORA AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3043
Practice Address - Country:US
Practice Address - Phone:626-671-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental