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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 (PPOCOORDINATOR)
(714) 480-3000
Entity
Organization
Contact information
Practice address
7541 SEPULVEDA BLVD, VAN NUYS, CA 91405-1645
(818) 908-2600
(818) 908-0647
Mailing address
7541 SEPULVEDA BLVD, VAN NUYS, CA 91405-1645
(818) 908-2600
(818) 908-0647
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90179-75
—
CA
Enumeration date
01/25/2007
Last updated
08/22/2020
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