Organization
STARLIDENT P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. XING FAN (DENTIST)
(617) 340-9178
Entity
Organization
Contact information
Practice address
517 WASHINGTON ST, NEWTON, MA 02458-1433
(617) 340-9178
Mailing address
524 CONCORD AVE, LEXINGTON, MA 02421-8010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855843
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110091024A
—
MA
Enumeration date
04/12/2012
Last updated
04/12/2012
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