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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 OPERATIONS OFFICER)
(714) 571-3372
Entity
Organization
Contact information
Practice address
4024 12TH ST, RIVERSIDE, CA 92501-3561
(951) 784-0636
(951) 784-0675
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
(714) 480-3000
(714) 571-6445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90179
—
CA
Enumeration date
03/13/2017
Last updated
03/02/2022
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