| Provider / Organization | NPI | Date Certified |
|---|---|---|
| RAYMOND FAN | 1962938522 | 2017-05-02 |
Raymond Fan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1962938522. Registration indicates Raymond Fan is a provider of access to dental specialists services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist: Oral and Maxillofacial Surgery, ) (Dental, ) (Dentist Oral and Maxillofacial Surgery, Dental Providers) (Dentist, ) Access to Dental Specialists (Dental Providers, Dentist) (Dental Providers, Dentist) (Dentist: Oral and Maxillofacial Surgery, ) (Dental, ) (Dentist Oral and Maxillofacial Surgery, Dental Providers) (Dentist, ) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Raymond Fan DDS |
| Practice Office Address | 12860 10TH ST CHINO, CA US |
| Practice Office Telephone | 9095910241 |
| Mailing Address | 1600 S ANDREWS AVE FORT LAUDERDALE, FL 333162510 US |
| Business Telephone | 9544592094 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1500 S Main St | Fort Worth, TX 761044917 | 8177021173 |
| 1600 S Andrews Ave | Fort Lauderdale, FL 333162510 | 9543554400 |
| 12218 Apple Valley Rd Ste 110 | Apple Valley, CA 923081704 | 7603003678 |
| 2800 Coors Blvd NW Ste A | Albuquerque, NM 871201204 | 5053521166 |
| Code | Practice | License No State |
|---|---|---|
| 1223S0112X | Access to Dental Specialists Dental Providers Dentist Dental Providers Dentist Dentist: Oral and Maxillofacial Surgery Dental Dentist Oral and Maxillofacial Surgery Dental Providers Dentist | DD5682
NM |
| 1223S0112X PRIMARY | Access to Dental Specialists Dental Providers Dentist Dental Providers Dentist Dentist: Oral and Maxillofacial Surgery Dental Dentist Oral and Maxillofacial Surgery Dental Providers Dentist | DDS104689
CA |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |