NPI 1003238650

Isse Song

Practitioner General Practice Dentistry Orlando, FL

Practice location

Address: 12554 S John Young Pkwy Suite104, Orlando, FL 32837-4004
Phone: (407) 888-1088
Fax: (407) 888-1089

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence DN11703 (FL)

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Registry record

NPI: 1003238650
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jan 2014
Record last updated: 16 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.