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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
2626 MISSION ST, SAN FRANCISCO, CA 94110-3102
(415) 285-7500
(415) 285-9847
Mailing address
PO BOX 51022, LOS ANGELES, CA 90051-5322
(714) 480-3000
(714) 571-6445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90179-38
—
CA
Enumeration date
12/20/2006
Last updated
03/20/2018
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