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Organization
WESTERN DENTAL SERVICES, INC.
Active
Organization
WESTERN DENTAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SILVIA DIAZ (PPO COORDINATOR)
(714) 480-3000
Entity
Organization
Contact information
Practice address
169 S RANCHO SANTA FE RD, SAN MARCOS, CA 92078-2501
(760) 916-9595
(760) 916-9604
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
(714) 480-3000
(714) 571-6445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G92150-
—
CA
Enumeration date
03/23/2012
Last updated
03/23/2012
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