Western Dental Service, Inc | |
2700 Colorado Blvd Ste 263 Eagle Rock CA 90041-1048 | |
(323) 987-2175 | |
(714) 571-6445 |
Full Name | Western Dental Service, Inc |
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Speciality | Dentist |
Location | 2700 Colorado Blvd Ste 263, Eagle Rock, California |
Authorized Official Name and Position | Preet Takkar (CHIEF OPERATIONS OFFICER) |
Authorized Official Contact | 7145713372 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Western Dental Service, Inc 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Service, Inc 2700 Colorado Blvd Ste 263 Eagle Rock CA 90041-1048 Ph: (323) 987-2175 |
NPI Number | 1881110351 |
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Provider Enumeration Date | 08/16/2017 |
Last Update Date | 06/30/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881110351 | NPI | - | NPPES |
G90179 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |