| Western Dental Services, Inc. | |
|
36416 Fremont Blvd Fremont CA 94536-7436 | |
| (510) 739-3889 | |
| (510) 251-8013 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 36416 Fremont Blvd, Fremont, California |
| Authorized Official Name and Position | Maribel Zamora (ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 7145713104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Dental Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Services, Inc. 36416 Fremont Blvd Fremont CA 94536-7436 Ph: (510) 739-3889 |
| NPI Number | 1720564826 |
|---|---|
| Provider Enumeration Date | 07/12/2018 |
| Last Update Date | 07/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720564826 | NPI | - | NPPES |
| G90179 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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