MEDICARE: WESTWOOD DENTAL SMILES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	40203	CA

General Provider Information

NPI Number	:	1457576324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTWOOD DENTAL SMILES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 241710
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-9510
Country	:	US
Telephone Number	:	310-208-4084
Fax Number	:	310-208-3826

Provider Business Practice Location Address
First Line	:	10921 WILSHIRE BLVD STE 1112
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4005
Country	:	US
Telephone Number	:	310-208-4084
Fax Number	:	310-208-3826

Authorized Official
Title or Position	:	DR
Name	:	TOMAS ANDERKVIST
Credential	:	DDS
Telephone Number	:	310-208-4084

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	10/06/2008

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Directions to “WESTWOOD DENTAL SMILES, INC. ” Practice Location

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