Individual
DR. SONNY SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 ELMWOOD AVE # 683, ROCHESTER, NY 14620-2913
(585) 275-8315
Mailing address
625 ELMWOOD AVE # 683, ROCHESTER, NY 14620-2913
(585) 275-8315
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401417149
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2018
Last updated
11/12/2020
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