| Western Dental Services, Inc. | |
|
617 N Main St Corona CA 92880-1467 | |
| (951) 736-9508 | |
| (951) 738-1352 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 617 N Main St, Corona, California |
| Authorized Official Name and Position | Preet Takkar (CHIEF INFORMATION OFFICER) |
| Authorized Official Contact | 7145713372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Dental Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000 | Western Dental Services, Inc. 617 N Main St Corona CA 92880-1467 Ph: (951) 736-9508 |
| NPI Number | 1215099536 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 03/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215099536 | NPI | - | NPPES |
| G90179-11 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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