Individual
DR. JONATHAN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
115 W SEMINARY DR, SUITE 101, FORT WORTH, TX 76115-2635
(817) 405-0195
Mailing address
115 W SEMINARY DR, SUITE 101, FORT WORTH, TX 76115-2635
(817) 405-0195
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31771
TX
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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