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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
MRS. MARINA KING (PPO COORDINATOR)
(714) 480-3000
Entity
Organization
Contact information
Practice address
1670 LINCOLN BLVD, SANTA MONICA, CA 90404-3712
(310) 392-3533
(310) 392-3794
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
(714) 480-3000
(714) 571-3560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90179-36
—
CA
Enumeration date
12/20/2006
Last updated
08/22/2020
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