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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
CINDY E. AVALOS (DENTICAL ASSISTANT MANAGER)
(714) 480-3000
Entity
Organization
Contact information
Practice address
3587 SONOMA BLVD, VALLEJO, CA 94590-2945
(707) 557-8000
(707) 557-8030
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
(714) 480-3000
(714) 571-3598
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G92150-
—
CA
Enumeration date
06/19/2008
Last updated
06/19/2008
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