Individual
BENJAMIN FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4517 TUSCANY DR, PLANO, TX 75093-7043
(214) 395-1217
Mailing address
4517 TUSCANY DR, PLANO, TX 75093-7043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25777
TX
Other
Enumeration date
08/02/2010
Last updated
06/07/2012
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