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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
PREET TAKKAR (CHIEF INFORMATION OFFICER)
(714) 571-3372
Entity
Organization
Contact information
Practice address
14244 HAWTHORNE BLVD, HAWTHORNE, CA 90250-7008
(310) 219-1234
(310) 978-0380
Mailing address
14244 HAWTHORNE BLVD, HAWTHORNE, CA 90250-7008
(310) 219-1234
(310) 978-0380
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90179-43
—
CA
Enumeration date
01/25/2007
Last updated
10/28/2019
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