| Western Dental Services, Inc. | |
|
1111 W 6th St Suite 120 Los Angeles CA 90017-1800 | |
| (213) 895-0009 | |
| (213) 895-0012 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1111 W 6th St, Los Angeles, 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. 1111 W 6th St Suite 120 Los Angeles CA 90017-1800 Ph: (213) 895-0009 |
| NPI Number | 1710428552 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 03/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710428552 | NPI | - | NPPES |
| G90179 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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