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6059 Atlantic Blvd Maywood CA 90270-3118 | |
| (323) 560-3131 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6059 Atlantic Blvd, Maywood, California |
| Authorized Official Name and Position | Terry D Ahn (OWNER) |
| Authorized Official Contact | 3235603131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6059 Atlantic Blvd Maywood CA 90270-3118 Ph: (323) 560-3131 | 6059 Atlantic Blvd Maywood CA 90270-3118 Ph: (323) 560-3131 |
| NPI Number | 1922491273 |
|---|---|
| Provider Enumeration Date | 03/11/2015 |
| Last Update Date | 03/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922491273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 54576 (California) | 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 |