| Western Dental Services, Inc. | |
|
3587 Sonoma Blvd Vallejo CA 94590-2945 | |
| (707) 557-8000 | |
| (707) 557-8030 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 3587 Sonoma Blvd, Vallejo, California |
| Authorized Official Name and Position | Cindy E. Avalos (DENTICAL ASSISTANT MANAGER) |
| 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. 3587 Sonoma Blvd Vallejo CA 94590-2945 Ph: (707) 557-8000 |
| NPI Number | 1316108657 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316108657 | NPI | - | NPPES |
| G92150- | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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