MEDICARE: GREWALZ PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1720784374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREWALZ PLLC

Provider Business Mailing Address
First Line	:	355 ATLANTIC ST APT 16D
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06901-3550
Country	:	US
Telephone Number	:	347-251-7242
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 CHESTNUT HILL RD
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-2524
Country	:	US
Telephone Number	:	347-251-7242
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. YASMIN GREWAL
Credential	:	DDS
Telephone Number	:	347-251-7242

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	02/06/2023

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