| NPI | 1003079468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YONG CHOL SONG President 972-906-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16398) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2017-04-17 |