Organization
CONANT STREET DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEUNGHEE SONG (DENTIST)
(978) 774-3331
Entity
Organization
Contact information
Practice address
36 CONANT ST STE 4, DANVERS, MA 01923-2954
(978) 774-3331
(978) 774-3331
Mailing address
36 CONANT ST STE 4, DANVERS, MA 01923-2954
(978) 774-3331
(978) 774-3331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN22272
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871741983
NPI
MA
Enumeration date
11/04/2014
Last updated
11/04/2014
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