Individual
DR. SONG B RHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2133 PEPPERRELL ST, JBSA LACKLAND, TX 78236-5313
(210) 292-2558
Mailing address
2133 PEPPERRELL ST, JBSA LACKLAND, TX 78236-5313
(210) 292-2558
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
13473
MD
1223P0300X
Periodontics
62275
CA
1223P0300X
Periodontics
Primary
D1034
GU
1223P0300X
Periodontics
DDS62275
CA
Other
Enumeration date
04/26/2007
Last updated
01/05/2021
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