Healthcare Provider Details

I. General information

NPI: 1982552451
Provider Name (Legal Business Name): WILLIAM A GRELLA JR DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 E PACIFIC COAST HWY STE 201
LONG BEACH CA
90804-3315
US

IV. Provider business mailing address

5175 E PACIFIC COAST HWY STE 201
LONG BEACH CA
90804-3315
US

V. Phone/Fax

Practice location:
  • Phone: 562-597-1543
  • Fax: 562-494-6824
Mailing address:
  • Phone: 562-597-1543
  • Fax: 562-494-6824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM ALBERT GRELLA JR.
Title or Position: OWNER
Credential: DDS
Phone: 562-597-1543