Individual
NAMI SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
432 MAIN ST, DANBURY, CT 06810-4730
(646) 266-0168
Mailing address
432 MAIN ST, DANBURY, CT 06810-4730
(646) 266-0168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010139
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/05/2008
Last updated
07/21/2014
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