| Wilshire Westgate Dental, Inc. | |
|
11860 Wilshire Blvd #302 Los Angeles CA 90025-6613 | |
| (310) 478-3511 | |
| Not Available |
| Full Name | Wilshire Westgate Dental, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11860 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Cary Charlin (OWNER) |
| Authorized Official Contact | 3104783511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilshire Westgate Dental, Inc. 11860 Wilshire Blvd #302 Los Angeles CA 90025-6613 Ph: (310) 478-3511 | Wilshire Westgate Dental, Inc. 11860 Wilshire Blvd #302 Los Angeles CA 90025-6613 Ph: (310) 478-3511 |
| NPI Number | 1619274420 |
|---|---|
| Provider Enumeration Date | 02/15/2011 |
| Last Update Date | 01/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619274420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 36346 (California) | Primary |
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