| NPI | 1356756423 |
|---|---|
| Doing Business As | LONG RIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIGON SONG Owner 646-369-6918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2015-03-02 |