Organization
FAN OF DENTISTRY PLLC
Active
Other names
Fan Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN FAN D.D.S. (OWNER)
(214) 395-1217
Entity
Organization
Contact information
Practice address
689 W RENNER RD, RICHARDSON, TX 75080-1345
(972) 234-5700
Mailing address
4517 TUSCANY DR, PLANO, TX 75093-7043
(214) 395-1217
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25777
TX
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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