# KEVIN SONG, DDS, PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164761540
- **Authorized official:** DR. KEVIN SONG DDS (PRESIDENT)
- **Authorized official phone:** (253) 475-1521

## Contact information

- **Practice address:** 5221 PACIFIC AVE, TACOMA, WA 98408-7625
- **Practice address phone:** (253) 475-1521
- **Mailing address:** 5221 PACIFIC AVE, TACOMA, WA 98408-7625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 60065174 | WA | Yes |

## Other

- **Enumeration date:** 02/05/2013
- **Last updated:** 02/05/2013