| Western Dental Services, Inc. | |
|
1237 E Grand Ave Ste 102 Arroyo Grande CA 93420-2419 | |
| (805) 346-2713 | |
| (805) 686-7740 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1237 E Grand Ave Ste 102, Arroyo Grande, California |
| Authorized Official Name and Position | William Dale Demberecky (EVP & CHIEF STRATEGY AND GROWTH) |
| Authorized Official Contact | 7145712140 |
| 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. 1237 E Grand Ave Ste 102 Arroyo Grande CA 93420-2419 Ph: (805) 346-2713 |
| NPI Number | 1093419681 |
|---|---|
| Provider Enumeration Date | 03/28/2023 |
| Last Update Date | 03/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093419681 | NPI | - | NPPES |
| G86209 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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