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Organization
VON WESTERNHAGEN DENTAL CORPORATION
Active
Organization
VON WESTERNHAGEN DENTAL CORPORATION
Active
Other names
CanAm Dental
Organization subpart
No
Provider details
NPI number
Authorized official
PETER STATHAKIS (STAFF)
(312) 274-4546
Entity
Organization
Contact information
Practice address
9610 SIERRA AVE, SUITE 200, FONTANA, CA 92335
(909) 219-8700
Mailing address
9610 SIERRA AVE, SUITE 200, FONTANA, CA 92335
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/26/2022
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