Individual
DR. BASSAM W FARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8275 SIERRA AVE STE 102, FONTANA, CA 92335-3557
(951) 329-7904
Mailing address
11559 SPRINGWOOD CT, RIVERSIDE, CA 92505-5116
(951) 329-7904
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101625
CA
Other
Enumeration date
07/27/2017
Last updated
03/11/2020
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