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General NPI Number Information
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NPI Number | 1356902258
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Entity Type | Individual
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Provider Name | YOUNG KYUNG SONG DDS
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Gender | Female
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Dates
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Enumeration Date | 06/22/2019
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 130 W MCCART ST
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City | KRUM
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State | TX
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Zip | 76249-5552
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Country | US
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Telephone | 940-398-3135
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Fax |
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Provider Business Mailing Address
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Address Line | 130 W MCCART ST
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City | KRUM
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State | TX
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Zip | 76249-5552
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Country | US
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Telephone | 860-416-0331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 35242
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License Number State | TX
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