Provider Demographics
NPI:1457576324
Name:WESTWOOD DENTAL SMILES, INC.
Entity Type:Organization
Organization Name:WESTWOOD DENTAL SMILES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERKVIST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-208-4084
Mailing Address - Street 1:PO BOX 241710
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-9510
Mailing Address - Country:US
Mailing Address - Phone:310-208-4084
Mailing Address - Fax:310-208-3826
Practice Address - Street 1:10921 WILSHIRE BLVD STE 1112
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4005
Practice Address - Country:US
Practice Address - Phone:310-208-4084
Practice Address - Fax:310-208-3826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA402031223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty