Sph Bridgeport, LLC
NPI #1194193094 in Bridgeport, Connecticut
Provider Information
- NPI Number
- 1194193094
- Entity Type
- Organization
- Organization Name
- Sph Bridgeport, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 9, 2015
- Last Updated
- Sep 9, 2015
Practice Location
- Address
- 161 BOSTON AVE
- City
- Bridgeport
- State
- Connecticut
- ZIP Code
- 06610-1662
- Phone
- (203) 873-0598
Authorized Official
- Name
- DR. KIGONS SONG, DDS
- Title
- OWNER
- Phone
- (646) 369-6918
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
| Dentist - General Practice — General Practice |
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