Western Dental Services, Inc. | |
5776 N Blackstone Ave Ste 104 Fresno CA 93710-5026 | |
(559) 650-1457 | |
(559) 650-1456 |
Full Name | Western Dental Services, Inc. |
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Speciality | Dentist |
Location | 5776 N Blackstone Ave Ste 104, Fresno, 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. 5776 N Blackstone Ave Ste 104 Fresno CA 93710-5026 Ph: (559) 650-1457 |
NPI Number | 1295209823 |
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Provider Enumeration Date | 01/16/2019 |
Last Update Date | 03/28/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295209823 | NPI | - | NPPES |
G90179 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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