| Western Dental Services, Inc | |
|
1110 S King Rd Suite 60 San Jose CA 95122-2118 | |
| (408) 273-7252 | |
| (408) 273-7270 |
| Full Name | Western Dental Services, Inc |
|---|---|
| Speciality | Dentist |
| Location | 1110 S King Rd, San Jose, California |
| Authorized Official Name and Position | Silvia S Diaz (PPO COORDINATOR) |
| Authorized Official Contact | 7144803000 |
| 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: () - | Western Dental Services, Inc 1110 S King Rd Suite 60 San Jose CA 95122-2118 Ph: (408) 273-7252 |
| NPI Number | 1295025898 |
|---|---|
| Provider Enumeration Date | 04/15/2011 |
| Last Update Date | 04/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295025898 | NPI | - | NPPES |
| G92150 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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