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Individual

DR. JUN S SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MMSC

Contact information

Practice address
46-01 BELL BLVD., BAYSIDE, NY 11361
(718) 281-2222
(718) 281-2822
Mailing address
46-01 BELL BLVD., BAYSIDE, NY 11361
(718) 281-2222
(718) 281-2822

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
048211
NY
1223P0300X
Periodontics
Primary
048211
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02455109
NY
Enumeration date
05/08/2007
Last updated
10/04/2018
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