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1831455955
JACK FAN
AUSTIN, TX
NPI
1831455955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: TX 28806)
Enumeration Date
2012-04-03
Last Update Date
2016-11-09
Business Address
-- JACK FAN DDS
4301 W WILLIAM CANNON DR BLDG B, SUITE 240
AUSTIN, TX 78749-1473
Phone number: 512-892-7800
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Mailing Address
-- JACK FAN DDS
4301 W WILLIAM CANNON DR BLDG B, SUITE 240
AUSTIN, TX 78749-1473
Phone number: 512-892-7800
Copy
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