| Western Dental Services, Inc. | |
|
1200 W Martin Luther King Jr Blvd Los Angeles CA 90037-1722 | |
| (323) 295-8004 | |
| (323) 296-3285 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1200 W Martin Luther King Jr 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 |
|---|---|
| Western Dental Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Services, Inc. 1200 W Martin Luther King Jr Blvd Los Angeles CA 90037-1722 Ph: (323) 295-8004 |
| NPI Number | 1912061417 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 10/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912061417 | NPI | - | NPPES |
| G90179-13 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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