Provider Demographics
NPI:1790707081
Name:GREWAL, NANCY (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
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 1:7 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1912
Mailing Address - Country:US
Mailing Address - Phone:908-835-0800
Mailing Address - Fax:908-835-8952
Practice Address - Street 1:7 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1912
Practice Address - Country:US
Practice Address - Phone:908-835-0800
Practice Address - Fax:908-835-8952
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021967001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice