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General NPI Number Information
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NPI Number | 1417562448
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Entity Type | Individual
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Provider Name | YASMIN GREWAL DDS
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 3154 DE FOREST RD STE D
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City | MARINA
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State | CA
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Zip | 93933-2771
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Country | US
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Telephone | 831-900-4435
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Fax |
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Provider Business Mailing Address
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Address Line | 3556 KEYSTONE AVE APT 8
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City | LOS ANGELES
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State | CA
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Zip | 90034-5535
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Country | US
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Telephone | 347-251-7242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 105519
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License Number State | CA
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