Provider Demographics
NPI:1982798732
Name:ALEX SONG DDS APC
Entity Type:Organization
Organization Name:ALEX SONG DDS APC
Other - Org Name:A1 DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-450-6060
Mailing Address - Street 1:7780 S JONES BLVD #101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139
Mailing Address - Country:US
Mailing Address - Phone:702-450-6060
Mailing Address - Fax:702-871-7272
Practice Address - Street 1:7780 S JONES BLVD #101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139
Practice Address - Country:US
Practice Address - Phone:702-450-6060
Practice Address - Fax:702-871-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty