| Westport Dental | |
|
420 S State College Blvd Anaheim CA 92806-4119 | |
| (714) 772-0770 | |
| (714) 772-7054 |
| Full Name | Westport Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 420 S State College Blvd, Anaheim, California |
| Authorized Official Name and Position | Manhar Mistry (PRESIDENT) |
| Authorized Official Contact | 7146064908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Westport Dental 420 S State College Blvd Anaheim CA 92806-4119 Ph: (714) 772-0770 | Westport Dental 420 S State College Blvd Anaheim CA 92806-4119 Ph: (714) 772-0770 |
| NPI Number | 1891183877 |
|---|---|
| Provider Enumeration Date | 12/29/2014 |
| Last Update Date | 12/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891183877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 28045 (California) | Primary |
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