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General NPI Number Information
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NPI Number | 1568988186
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Entity Type | Individual
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Provider Name | STEVE SONG DDS
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Gender | Male
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 9225 DOERR RD BLDG 1229
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City | FORT BELVOIR
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State | VA
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Zip | 22060-2204
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Country | US
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Telephone | 571-231-6054
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Fax |
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Provider Business Mailing Address
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Address Line | 8476 SIMMOND ST
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City | FORT GEORGE G MEADE
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State | MD
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Zip | 20755-7083
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Country | US
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Telephone | 301-677-6122
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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 | 2901022187
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 2901022187
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License Number State | MI
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