Organization
WEST DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY THOMAS WEST DDS (PRESIDENT)
(209) 526-0462
Entity
Organization
Contact information
Practice address
1236 FLOYD AVE STE C, MODESTO, CA 95350-2472
(209) 524-5515
Mailing address
1500 MCHENRY AVE, MODESTO, CA 95350-4529
(209) 526-0462
(209) 526-9223
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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