Individual
DR. SEJIN SHANE SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
107 WASHBURNE AVE, PAYNESVILLE, MN 56362-1640
(320) 243-2175
(320) 243-8158
Mailing address
107 WASHBURNE AVENUE, PAYNESVILLE, MN 56362
(320) 243-2175
(320) 243-8158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13182
MN
Other
Enumeration date
01/21/2010
Last updated
09/07/2016
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