Park, Song Yong
Park, Song Yong is an individual health care provider with primary practice located at 34 Benwood Ave , Buffalo NY 14214-1761. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Park, Song Yong can be contacted via phone (716) 986-9199.Contact Information
Primary practice address
34 Benwood Ave
Buffalo NY 14214-1761
Phone: (716) 986-9199
Fax: (716) 342-2340
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 059200 | New York |
Profile Details
| NPI number | 1225486947 |
|---|---|
| LBN Legal business name | Park, Song Yong |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 3rd, 2016 |
| Last updated | Jun 11th, 2026 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225486947 | NPPES |
| New York | MEDICAID | 04880291 |
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