Western Dental Services, Inc. | |
1240 Farmers Ln Santa Rosa CA 95405-6707 | |
(707) 542-5200 | |
(707) 579-3207 |
Full Name | Western Dental Services, Inc. |
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Speciality | Dentist - General Practice |
Location | 1240 Farmers Ln, Santa Rosa, California |
Authorized Official Name and Position | Marina King (PPO COORDINATOR) |
Authorized Official Contact | 7144803000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Western Dental Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Services, Inc. 1240 Farmers Ln Santa Rosa CA 95405-6707 Ph: (707) 542-5200 |
NPI Number | 1417009598 |
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Provider Enumeration Date | 01/17/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417009598 | NPI | - | NPPES |
G90179-54 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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