Individual
DR. RICHARD SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3123 KENNEDY BLVD, NORTH BERGEN, NJ 07047-2378
(201) 662-0662
Mailing address
160 MORGAN ST APT 1504, JERSEY CITY, NJ 07302-6254
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02892700
NJ
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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