| Western Dental Services, Inc. | |
|
3325 Palo Verde Ave Suite 208 Long Beach CA 90808-4132 | |
| (562) 429-1642 | |
| (562) 429-1643 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 3325 Palo Verde Ave, Long Beach, California |
| Authorized Official Name and Position | John Luther (CHIEF DENTAL OFFICER) |
| 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. 3325 Palo Verde Ave Suite 208 Long Beach CA 90808-4132 Ph: (562) 429-1642 |
| NPI Number | 1740721588 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 03/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740721588 | NPI | - | NPPES |
| G90179 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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