Provider Demographics
NPI:1841344850
Name:MELQUIADES V FRONDA DDS INC
Entity type:Organization
Organization Name:MELQUIADES V FRONDA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELQUIADES
Authorized Official - Middle Name:VASQUEZ
Authorized Official - Last Name:FRONDA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-882-3706
Mailing Address - Street 1:2102 N ARROWHEAD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405
Mailing Address - Country:US
Mailing Address - Phone:909-882-3706
Mailing Address - Fax:909-882-3707
Practice Address - Street 1:2102 N ARROWHEAD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4021
Practice Address - Country:US
Practice Address - Phone:909-882-3706
Practice Address - Fax:909-882-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADZ369221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty