| Western Dental Services, Inc. | |
|
9765 Sierra Ave Ste A Fontana CA 92335-6777 | |
| (909) 427-8000 | |
| (909) 427-8719 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9765 Sierra Ave Ste A, Fontana, California |
| Authorized Official Name and Position | Cindy E Avalos (PPOCOORDINATOR) |
| Authorized Official Contact | 7144803000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Dental Services, Inc. 9765 Sierra Ave Ste A Fontana CA 92335-6777 Ph: (909) 427-8000 | Western Dental Services, Inc. 9765 Sierra Ave Ste A Fontana CA 92335-6777 Ph: (909) 427-8000 |
| NPI Number | 1275689663 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275689663 | NPI | - | NPPES |
| G90179-73 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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