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General NPI Number Information
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NPI Number | 1003760885
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Entity Type | Organization
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Legal Business Name | MOHAN BAJWA DDS INC
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 5041 BUSINESS CENTER DR STE 106
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City | FAIRFIELD
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State | CA
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Zip | 94534-1787
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Country | US
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Telephone | 707-863-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 5041 BUSINESS CENTER DR STE 106
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City | FAIRFIELD
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State | CA
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Zip | 94534-1787
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Country | US
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Telephone | 707-863-9950
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHAN BAJWA
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Credential | DDS
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Telephone | 707-863-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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