Organization
LILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YUNBO SONG (PRESIDENT)
(718) 576-1558
Entity
Organization
Contact information
Practice address
837 59TH ST FL 3, BROOKLYN, NY 11220-5577
(718) 576-1558
Mailing address
837 59TH ST FL 3, BROOKLYN, NY 11220-5577
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05703168
—
NY
Enumeration date
03/23/2022
Last updated
09/26/2024
Update your record
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