Individual
PHILIP PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5005 S COOPER ST, ST 173, ARLINGTON, TX 76017
(817) 635-6453
Mailing address
5005 S COOPER ST STE 173, ARLINGTON, TX 76017-8600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27170
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
27170
TX
Other
Enumeration date
07/20/2011
Last updated
01/19/2023
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