| Fan Family Dental | |
|
689 W Renner Rd Richardson TX 75080-1345 | |
| (972) 234-5700 | |
| Not Available |
| Full Name | Fan Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 689 W Renner Rd, Richardson, Texas |
| Authorized Official Name and Position | Benjamin Fan (OWNER) |
| Authorized Official Contact | 2143951217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fan Family Dental 4517 Tuscany Dr Plano TX 75093-7043 Ph: (214) 395-1217 | Fan Family Dental 689 W Renner Rd Richardson TX 75080-1345 Ph: (972) 234-5700 |
| NPI Number | 1619307105 |
|---|---|
| Provider Enumeration Date | 11/19/2013 |
| Last Update Date | 11/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619307105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 25777 (Texas) | Primary |
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