Myoungsu Song
Myoungsu Song is a General Practice Dentistry in Champaign, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2020
Practice location Address checks out
819 Bloomington RdChampaign, IL 61820-2101
Phone: (217) 356-1558
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 019032794 (IL) |
|---|
Record details
| NPI number | 1154932218 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | August 12, 2020 |
| Last updated in NPPES | January 24, 2023 |
| Certification date | January 24, 2023 |
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