Individual
DR. JASON LIDDELL PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
985 MAIN ST, MELROSE, MA 02176-1913
(781) 665-5190
Mailing address
94 LARCHMONT RD, MELROSE, MA 02176-2503
(617) 272-5677
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1858638
MA
Other
Enumeration date
05/24/2019
Last updated
08/26/2020
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