Provider Demographics
NPI:1356923072
Name:CYPRESS PLAZA DENTAL GROUP
Entity type:Organization
Organization Name:CYPRESS PLAZA DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MANPREET
Authorized Official - Middle Name:G
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-226-9630
Mailing Address - Street 1:5460 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3740
Mailing Address - Country:US
Mailing Address - Phone:714-226-9630
Mailing Address - Fax:714-226-0190
Practice Address - Street 1:5460 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3740
Practice Address - Country:US
Practice Address - Phone:714-226-9630
Practice Address - Fax:714-226-0190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANPREET G GREWAL DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental