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General NPI Number Information
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NPI Number | 1376996678
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Entity Type | Organization
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Legal Business Name | WESTWOOD DENTAL ASSOCIATES INC
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Dates
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Enumeration Date | 07/21/2016
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 10921 WILSHIRE BLVD #112
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City | LOS ANGELES
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State | CA
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Zip | 90024-3906
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Country | US
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Telephone | 310-208-7727
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Fax |
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Provider Business Mailing Address
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Address Line | 10921 WILSHIRE BLVD #112
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City | LOS ANGELES
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State | CA
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Zip | 90024-3906
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Country | US
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Telephone | 310-208-7727
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS LEE
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Credential | DDS
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Telephone | 310-208-7727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 39976
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License Number State | CA
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