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Kenneth Fan, DDS
Orofacial Pain Dentist in Jbsa Lackland Afb, Texas
NPI 1588986566

Kenneth Fan is a Orofacial Pain Dentist based in Jbsa Lackland Afb, TX and is specialized in Orofacial Pain. Kenneth Fan practices in Jbsa Lackland Afb, TX and has the professional credentials of DDS. The NPI Number for Kenneth Fan is 1588986566 and holds a License No. DDS61109 (Texas).

The current practice location address for Kenneth Fan is 1110 Wilford Hall Loop, Jbsa Lackland Afb, TX and can be reached out via phone at 210-539-7866.

Location: 1110 Wilford Hall Loop, Jbsa Lackland Afb, TX, 78236
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588986566
Provider Name
Kenneth Fan
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1110 Wilford Hall Loop, Jbsa Lackland Afb, TX, 78236
Phone Number
210-539-7866
Fax Number
Provider Enumeration Date
02/18/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1110 Wilford Hall Loop
City
Jbsa Lackland Afb
State
Texas
Zip
78236
Phone Number
210-539-7866
Fax Number
person
Provider Business Mailing Address Details
Address
1110 Wilford Hall Loop
City
Jbsa Lackland Afb
State
Texas
Zip
78236
Phone Number
210-539-7866
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Orofacial Pain
Taxonomy
1223X2210X
License No.
DDS61109 (California)
Definition
A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.
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