Individual
JACK FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1125 N MCCARRAN BLVD STE 109, SPARKS, NV 89431-4607
(775) 391-8996
Mailing address
1125 N MCCARRAN BLVD STE 109, SPARKS, NV 89431-4607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8075
NV
Other
Enumeration date
05/31/2023
Last updated
10/03/2024
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