| Western Dental Services, Inc. | |
|
3880 Chicago Ave Riverside CA 92507-5354 | |
| (951) 643-6100 | |
| (951) 643-6105 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 3880 Chicago Ave, Riverside, California |
| Authorized Official Name and Position | Donna Blazio (ENROLLMENT MANAGER) |
| Authorized Official Contact | 7145713395 |
| 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. 3880 Chicago Ave Riverside CA 92507-5354 Ph: (951) 643-6100 |
| NPI Number | 1548637077 |
|---|---|
| Provider Enumeration Date | 09/01/2015 |
| Last Update Date | 09/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548637077 | NPI | - | NPPES |
| G90179 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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