Organization · Type 2 NPI

Fargo Dental Corporation

Dental Clinic/Center · Fontana, CA

NPI number 1609418987 Active

Practice location

8275 Sierra Ave Ste 102
Fontana, CA 92335-3557

Fax (909) 823-8341

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

2 other providers at this address

Other dental clinic/center providers in Fontana

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NPI record

NPI: 1609418987
Entity type: Organization (Type 2)
Issued: Oct 8, 2019
Last updated: Mar 11, 2020
Status: Active

Other names

<unavail>
BJB Dental Group A Professional Dental Corporation · former legal business name

Authorized official

Dr. Bassam Wisam Fargo, DDS
Co-Owner/dentist
(951) 329-7904

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About NPI 1609418987

Fargo Dental Corporation's National Provider Identifier is 1609418987, issued on Oct 8, 2019. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Fontana, CA. The record was last updated on Mar 11, 2020.