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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
MARIBEL ZAMORA (ENROLLMENT COORDINATOR)
(714) 571-3104
Entity
Organization
Contact information
Practice address
21729 VANOWEN ST, CANOGA PARK, CA 91303-2618
(818) 898-0858
(818) 493-4309
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
(714) 571-3653
(714) 571-6445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90179
—
CA
Enumeration date
11/16/2017
Last updated
11/16/2017
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