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1053507087
EUN SUP SONG
LA CRESCENTA, CA
NPI
1053507087
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 42003)
Enumeration Date
2007-09-24
Last Update Date
2007-09-24
Business Address
Dr. EUN SUP SONG DDS
2777 FOOTHILL BLVD
LA CRESCENTA, CA 91214
Phone number: 818-957-7878
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Mailing Address
Dr. EUN SUP SONG DDS
2777 FOOTHILL BLVD
LA CRESCENTA, CA 91214
Phone number: 818-957-7878
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