Individual
DR. IN HEE SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
1004 FOWLER WAY STE 9, PLACERVILLE, CA 95667-5746
(530) 328-0360
(530) 328-0365
Mailing address
1004 FOWLER WAY STE 9, PLACERVILLE, CA 95667-5746
(530) 328-0360
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
059801
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
OMS125
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
294967
NY
Other
Enumeration date
02/18/2012
Last updated
02/10/2025
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