Individual
ISSE SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12554 S JOHN YOUNG PKWY, SUITE104, ORLANDO, FL 32837-4004
(407) 888-1088
(407) 888-1089
Mailing address
12554 S JOHN YOUNG PKWY, SUITE104, ORLANDO, FL 32837-4004
(407) 888-1088
(407) 888-1089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN11703
FL
Other
Enumeration date
01/16/2014
Last updated
01/16/2014
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