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Dr. Soo Kyung Song, DDS,MS
Pediatric Dentist in Fullerton, California
NPI 1750740072

Soo Kyung Song is a Pediatric Dentist based in Fullerton, CA and is specialized in Pediatric Dentistry. Soo Kyung Song practices in Fullerton, CA and has the professional credentials of DDS,MS. The NPI Number for Soo Kyung Song is 1750740072 and holds a License No. (California).

The current practice location address for Soo Kyung Song is 100 E Valencia Mesa Dr Ste 102, Fullerton, CA and can be reached out via phone at 714-992-5437.

Location: 100 E Valencia Mesa Dr Ste 102, Fullerton, CA, 92835-3816
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750740072
Provider Name
Soo Kyung Song
Credential
DDS,MS
Provider Entity Type
Individual
Gender
Female
Address
100 E Valencia Mesa Dr Ste 102, Fullerton, CA, 92835-3816
Phone Number
714-992-5437
Fax Number
Provider Enumeration Date
02/15/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
100 E Valencia Mesa Dr Ste 102
City
Fullerton
State
California
Zip
92835-3816
Phone Number
714-992-5437
Fax Number
person
Provider Business Mailing Address Details
Address
100 E Valencia Mesa Dr Ste 102
City
Fullerton
State
California
Zip
92835-3816
Phone Number
714-992-5437
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
101142 (California)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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