Dr. Andrew Wonbin Song, DMD
Dentist in Madison, WI. Individual provider (NPI-1).
NPI number1215596804
StatusActive
Last updated in NPPESOct 9, 2019
Details
- NPI
- 1215596804
- Entity type
- Individual (NPI-1)
- Name
- Dr. Andrew Wonbin Song
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2019
- Last updated
- Oct 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 1002090 | WI | Yes |
Practice location
2713 Marshall CtMadison, WI 53705-2255
Phone 608-442-4400
Mailing address
2713 Marshall CtMadison, WI 53705-2255
Phone 281-854-4403
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