# KAPIL GREWAL DDS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** New Age Dentistry, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831554989
- **Authorized official:** DR. KAPIL GREWAL DDS (MANAGING DENTIST)
- **Authorized official phone:** (415) 490-7704

## Contact information

- **Practice address:** 717 ENCINO PL NE STE 6, ALBUQUERQUE, NM 87102-2624
- **Practice address phone:** (505) 247-8005
- **Practice address fax:** (505) 843-8589
- **Mailing address:** 717 ENCINO PL NE STE 6, ALBUQUERQUE, NM 87102-2624
- **Mailing address phone:** (505) 247-8005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DD4182 | NM | Yes |

## Other

- **Enumeration date:** 12/16/2015
- **Last updated:** 04/04/2016