| Western Dental Services, Inc. | |
|
3485 Madison St Riverside CA 92504-3716 | |
| (951) 688-6949 | |
| (951) 688-6417 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3485 Madison St, Riverside, 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. 3485 Madison St Riverside CA 92504-3716 Ph: (951) 688-6949 |
| NPI Number | 1013071513 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 04/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013071513 | NPI | - | NPPES |
| G90179-14 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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