| NPI | 1659319655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISSE SONG D.M.D., Ph. D.,Fagd/ Doctor 407-888-1088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn11703) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-08-22 |