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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 S DIAZ (PPO COORDINATOR)
(714) 480-3000
Entity
Organization
Contact information
Practice address
1110 S KING RD, SUITE 60, SAN JOSE, CA 95122-2118
(408) 273-7252
(408) 273-7270
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G92150
—
CA
Enumeration date
04/15/2011
Last updated
04/15/2011
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