Individual
GYU-LE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
591 E TREMONT AVE, BRONX, NY 10457-4727
(646) 393-5181
Mailing address
591 E TREMONT AVE, BRONX, NY 10457-4727
(646) 393-5181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
058606-1
NY
Other
Enumeration date
03/05/2015
Last updated
01/22/2017
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