Organization
ISSE SONG PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISSE SONG (DENTIST)
(407) 888-1088
Entity
Organization
Contact information
Practice address
12554 S JOHN YOUNG PARKWAY, 104, ORLANDO FLORIDA, FL 32837
(407) 888-1088
Mailing address
12554 S JOHN YOUNG PARKWAY, 104, ORLANDO FLORIDA, FL 32837
(407) 888-1088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075248700
—
FL
Enumeration date
11/12/2013
Last updated
11/12/2013
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