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6040b Atlantic Blvd Maywood CA 90270-3119 | |
| (323) 476-7558 | |
| (323) 476-7576 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6040b Atlantic Blvd, Maywood, California |
| Authorized Official Name and Position | Rafael T Pou (DENTIST) |
| Authorized Official Contact | 9495143500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6040b Atlantic Blvd Maywood CA 90270-3119 Ph: (323) 476-7558 | 6040b Atlantic Blvd Maywood CA 90270-3119 Ph: (323) 476-7558 |
| NPI Number | 1134614134 |
|---|---|
| Provider Enumeration Date | 06/22/2018 |
| Last Update Date | 06/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134614134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Western Dental Services, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4487 Slauson Ave, Maywood, CA 90270 Phone: 323-773-9961 Fax: 323-773-6235 |