Provider Demographics
NPI:1164584801
Name:WESTWOOD, PATRICIA VETLESEN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:VETLESEN
Last Name:WESTWOOD
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4633 INGRAHAM ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-8713
Mailing Address - Country:US
Mailing Address - Phone:858-866-1551
Mailing Address - Fax:
Practice Address - Street 1:4633 INGRAHAM ST STE C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-8713
Practice Address - Country:US
Practice Address - Phone:858-866-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics