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Individual

HA NA SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
3440 W CACTUS RD, PHOENIX, AZ 85029-2222
(623) 688-3364
Mailing address
3440 W CACTUS RD, PHOENIX, AZ 85029-2222
(623) 688-3364

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401414062
VA
122300000X
Dentist
D010620
AZ
122300000X
Dentist
DE60223134
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401414062
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D010620
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE60223134
WA

Other

Enumeration date
04/08/2020
Last updated
06/04/2021
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