| Dental Center Of West La | |
|
1964 Westwood Blvd Ste 145 Los Angeles CA 90025-4683 | |
| (310) 474-5575 | |
| (310) 475-1172 |
| Full Name | Dental Center Of West La |
|---|---|
| Speciality | Dentist |
| Location | 1964 Westwood Blvd Ste 145, Los Angeles, California |
| Authorized Official Name and Position | Jacob J Slutsky (OWNER) |
| Authorized Official Contact | 3104745575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Center Of West La 1964 Westwood Blvd Ste 145 Los Angeles CA 90025-4683 Ph: (310) 474-5575 | Dental Center Of West La 1964 Westwood Blvd Ste 145 Los Angeles CA 90025-4683 Ph: (310) 474-5575 |
| NPI Number | 1134304728 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 01/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134304728 | NPI | - | NPPES |
| B40311 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 40311 (California) | Primary |
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