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Individual

DR. TARIM SONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS, MS

Contact information

Practice address
5625 NE ELAM YOUNG PKWY STE 300, HILLSBORO, OR 97124-6422
(503) 924-2248
Mailing address
6961 SE RED ALDER ST, HILLSBORO, OR 97123-2674
(847) 224-2015

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
65148
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D11016
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
65148
DENTAL LICENSE
CA
01
D11016
DENTAL LICENSE
OR
Enumeration date
05/26/2016
Last updated
03/07/2023
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