| NPI | 1104481761 |
|---|---|
| Doing Business As | DEREK SONG, DMD |
| Entity Type | Organization |
| Authorized Contact | SEUNGHAN SONG Dentist/Owner 781-272-5890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |