| Western Dental Services, Inc | |
|
4242 Beverly Blvd Los Angeles CA 90004-4430 | |
| (714) 480-3000 | |
| Not Available |
| Full Name | Western Dental Services, Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4242 Beverly Blvd, Los Angeles, California |
| Authorized Official Name and Position | Preet Takkar (CHIEF INFORMATION OFFICER) |
| Authorized Official Contact | 7145713372 |
| 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 4242 Beverly Blvd Los Angeles CA 90004-4430 Ph: (714) 480-3000 |
| NPI Number | 1871883090 |
|---|---|
| Provider Enumeration Date | 04/08/2011 |
| Last Update Date | 02/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871883090 | NPI | - | NPPES |
| G92150-49 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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