| Western Dental Services, Inc | |
|
4100 S El Camino Real San Mateo CA 94403-5131 | |
| (650) 235-1460 | |
| (650) 235-1469 |
| Full Name | Western Dental Services, Inc |
|---|---|
| Speciality | Dentist |
| Location | 4100 S El Camino Real, San Mateo, California |
| Authorized Official Name and Position | Silvia 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: (714) 480-3000 | Western Dental Services, Inc 4100 S El Camino Real San Mateo CA 94403-5131 Ph: (650) 235-1460 |
| NPI Number | 1154677763 |
|---|---|
| Provider Enumeration Date | 08/01/2012 |
| Last Update Date | 08/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154677763 | NPI | - | NPPES |
| G92150- | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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