Individual
MS. IMMI SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
1301 SOLANO AVE STE 101, ALBANY, CA 94706-1825
(510) 528-2220
(510) 528-2280
Mailing address
1301 SOLANO AVE STE 101, ALBANY, CA 94706-1825
(510) 528-2220
(510) 528-2280
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
40732
CA
Other
Enumeration date
03/28/2007
Last updated
06/14/2022
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