Western Dental Services, Inc | |
4242 Beverly Blvd Los Angeles CA 90004-4430 | |
(714) 480-3000 | |
Not Available |
Full Name | Western Dental Services, Inc |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 4242 Beverly Blvd, Los Angeles, 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 4242 Beverly Blvd Los Angeles CA 90004-4430 Ph: (714) 480-3000 |
NPI Number | 1871883090 |
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Provider Enumeration Date | 04/08/2011 |
Last Update Date | 02/04/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871883090 | NPI | - | NPPES |
G92150-49 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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