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Raymond Fan, DDS
Student in an Organized Health Care Education/Training Program in Chino, California
NPI 1962938522

Raymond Fan is a Student in an Organized Health Care Education/Training Program based in Fort Lauderdale, CA. Raymond Fan practices in Chino, CA and has the professional credentials of DDS. The NPI Number for Raymond Fan is 1962938522 and holds a License No. DD5682 (California).

The current practice location address for Raymond Fan is 12860 10Th St, Chino, CA and can be reached out via phone at 909-591-0241.

Location: 12860 10Th St, Chino, CA, 33316-2510
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962938522
Provider Name
Raymond Fan
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
12860 10Th St, Chino, CA, 33316-2510
Phone Number
909-591-0241
Fax Number
Provider Enumeration Date
05/02/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12860 10Th St
City
Chino
State
California
Zip
91710-4294
Phone Number
909-591-0241
Fax Number
person
Provider Business Mailing Address Details
Address
12860 10Th St
City
Chino
State
California
Zip
91710-4294
Phone Number
909-591-0241
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
DDS104689 (California)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
DD5682 (New Mexico)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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