Provider Demographics
NPI:1639915655
Name:GREWAL, ARSHDEEP KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:ARSHDEEP
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 1:2017 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-2824
Mailing Address - Country:US
Mailing Address - Phone:765-231-6253
Mailing Address - Fax:
Practice Address - Street 1:2017 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-2824
Practice Address - Country:US
Practice Address - Phone:765-231-6253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014403A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist