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Jack Fan, DDS
General Practice Dentistry in Austin, Texas
NPI 1831455955

Jack Fan is a General Practice Dentistry based in Austin, TX and is specialized in General Practice. Jack Fan practices in Austin, TX and has the professional credentials of DDS. The NPI Number for Jack Fan is 1831455955 and holds a License No. 28806 (Texas).

The current practice location address for Jack Fan is 4301 W William Cannon Dr, Austin, TX and can be reached out via phone at 512-892-7800 and via fax at 512-892-7805.

Location: 4301 W William Cannon Dr, Austin, TX, 78749-1473
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831455955
Provider Name
Jack Fan
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
4301 W William Cannon Dr, Austin, TX, 78749-1473
Phone Number
512-892-7800
Fax Number
512-892-7805
Provider Enumeration Date
04/03/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
TX 28806 01 TX TX LICENSE
institution
Provider Business Practice Location Address Details
Address
4301 W William Cannon Dr
City
Austin
State
Texas
Zip
78749-1473
Phone Number
512-892-7800
Fax Number
512-892-7805
person
Provider Business Mailing Address Details
Address
4301 W William Cannon Dr
City
Austin
State
Texas
Zip
78749-1473
Phone Number
512-892-7800
Fax Number
512-892-7805
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
28806 (Texas)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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