Individual
SHARON KYUNGHA SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
49 DAY ST, NORWALK, CT 06854-4901
(203) 854-9292
(203) 854-9437
Mailing address
635 MAIN ST, ATTN: CREDENTIALING DEPT, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009859
CT
1223G0001X
General Practice Dentistry
0520021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236354
—
CT
05
—
02678297
—
NY
Enumeration date
02/09/2007
Last updated
08/09/2011
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