Individual
DR. DENNIS SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
47664
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A96692
CA
Other
Enumeration date
02/27/2007
Last updated
05/21/2010
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