# MICHAEL S. SONG DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** POTOMAC VALLEY DENTAL CARE, PLLC
- **Other names:** FC dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336512342
- **Legal business name:** POTOMAC VALLEY DENTAL CARE, PLLC
- **Authorized official:** DR. MICHAEL S. SONG DDS (DENTIST/OWNER)
- **Authorized official phone:** (703) 385-5455

## Contact information

- **Practice address:** 3975 FAIR RIDGE DR, SUITE \#301N, FAIRFAX, VA 22033-2911
- **Practice address phone:** (703) 385-5455
- **Mailing address:** 3975 FAIR RIDGE DR, SUITE \#301N, FAIRFAX, VA 22033-2911
- **Mailing address phone:** (703) 385-5455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/12/2015
- **Last updated:** 11/12/2015