Individual
DR. BENJAMIN W SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2053 PALM VISTA DRIVE, APOPKA, FL 32712
(386) 235-6683
Mailing address
2053 PALM VISTA DR, APOPKA, FL 32712-2454
(386) 235-6683
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 21794
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/19/2011
Last updated
10/19/2016
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