| Western Dental Services, Inc. | |
|
2630 E Gage Ave Huntington Park CA 90255-4122 | |
| (323) 587-1788 | |
| (323) 584-2597 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2630 E Gage Ave, Huntington Park, 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 |
|---|---|
| Western Dental Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Services, Inc. 2630 E Gage Ave Huntington Park CA 90255-4122 Ph: (323) 587-1788 |
| NPI Number | 1972665297 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 10/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972665297 | NPI | - | NPPES |
| G90179-23 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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