Western Dental Services, Inc. | |
1600 Travis Blvd Fairfield CA 94533-3429 | |
(707) 429-4000 | |
(707) 429-3012 |
Full Name | Western Dental Services, Inc. |
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Speciality | Dentist |
Location | 1600 Travis Blvd, Fairfield, California |
Authorized Official Name and Position | Preet Takkar (CHIEF INFORMATION 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 Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Services, Inc. 1600 Travis Blvd Fairfield CA 94533-3429 Ph: (707) 429-4000 |
NPI Number | 1629542246 |
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Provider Enumeration Date | 01/16/2019 |
Last Update Date | 03/28/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629542246 | NPI | - | NPPES |
G90179 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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