| Bassam W. Fargo, Dds, Inc. | |
|
1717 3rd St Riverside CA 92507-3435 | |
| (951) 329-7904 | |
| Not Available |
| Full Name | Bassam W. Fargo, Dds, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1717 3rd St, Riverside, California |
| Authorized Official Name and Position | Bassam Wisam Fargo (OWNER) |
| Authorized Official Contact | 9513297904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bassam W. Fargo, Dds, Inc. 11559 Springwood Ct Riverside CA 92505-5116 Ph: (951) 329-7904 | Bassam W. Fargo, Dds, Inc. 1717 3rd St Riverside CA 92507-3435 Ph: (951) 329-7904 |
| NPI Number | 1154961522 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 03/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154961522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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