| Western Dental Services, Inc. | |
|
1245 N Lake Ave Pasadena CA 91104-2855 | |
| (626) 578-1200 | |
| (626) 568-2925 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1245 N Lake Ave, Pasadena, California |
| Authorized Official Name and Position | Preet Takkar (CHIEF OPERATIONS 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. 1245 N Lake Ave Pasadena CA 91104-2855 Ph: (626) 578-1200 |
| NPI Number | 1316009921 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 10/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316009921 | NPI | - | NPPES |
| G90179-02 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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