| Western Dental Services, Inc. | |
|
123 W Jackson St Hayward CA 94544-1809 | |
| (510) 887-5700 | |
| (510) 782-3730 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 123 W Jackson St, Hayward, California |
| Authorized Official Name and Position | Marina King (PPO COORDINATOR) |
| Authorized Official Contact | 7144803000 |
| 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. 123 W Jackson St Hayward CA 94544-1809 Ph: (510) 887-5700 |
| NPI Number | 1669536017 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669536017 | NPI | - | NPPES |
| G90179-66 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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