| Western Dental Services, Inc. | |
|
451 Blossom Hill Rd Suite 20 San Jose CA 95123 | |
| (408) 337-3622 | |
| (408) 337-3663 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 451 Blossom Hill Rd Suite 20, San Jose, California |
| Authorized Official Name and Position | Maribel Zamora (ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 7145713104 |
| 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. 451 Blossom Hill Rd Suite 20 San Jose CA 95123 Ph: (408) 337-3622 |
| NPI Number | 1003306176 |
|---|---|
| Provider Enumeration Date | 05/15/2018 |
| Last Update Date | 05/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003306176 | NPI | - | NPPES |
| G90179 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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