National Provider Identifier
Sonny Song
Sonny Song is listed in the NPPES registry with a primary specialty of Orthodontics And Dentofacial Orthopedics Dentistry in Rochester, NY and a listed phone number of (585) 275-8315.
Profile Overview
- NPI
- 1386132223
- Provider Type
- Individual
- Primary Specialty
- Orthodontics And Dentofacial Orthopedics Dentistry
- Enumeration Date
- April 26, 2018
- Last Updated
- November 12, 2020
Practice Location
- 625 Elmwood Ave # 683
- Rochester, NY 14620-2913
Phone: (585) 275-8315
Specialties
- Orthodontics And Dentofacial Orthopedics Dentistry (1223X0400X)
- Student In An Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1386132223
- Entity Type
- Individual
- Last Name
- Song
- First Name
- Sonny
- Name Prefix
- Dr.
- Mailing Street Address
- 625 Elmwood Ave # 683
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-2913
- Mailing Country
- US
- Mailing Phone
- (585) 275-8315
- Practice Street Address
- 625 Elmwood Ave # 683
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-2913
- Practice Country
- US
- Practice Phone
- (585) 275-8315
- Enumeration Date
- April 26, 2018
- Last Updated
- November 12, 2020
- Sex
- Male
- Sole Proprietor
- Yes
- Taxonomy Group 2
- 193400000X Single Specialty Group
- Certification Date
- November 12, 2020
- Taxonomies
- Orthodontics And Dentofacial Orthopedics Dentistry (1223X0400X), Student In An Organized Health Care Education/Training Program (390200000X)