Provider Demographics
NPI:1366580607
Name:FARSIO DENTAL CORPORATION
Entity type:Organization
Organization Name:FARSIO DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:FARSIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-546-1003
Mailing Address - Street 1:11180 WARNER AVE STE 351
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7516
Mailing Address - Country:US
Mailing Address - Phone:714-546-1003
Mailing Address - Fax:714-546-1031
Practice Address - Street 1:11180 WARNER AVE STE 351
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7516
Practice Address - Country:US
Practice Address - Phone:714-546-1003
Practice Address - Fax:714-546-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty