Provider Demographics
NPI:1083461065
Name:HYUN M. BAE DDS
Entity type:Organization
Organization Name:HYUN M. BAE DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIS
Authorized Official - Prefix:DR
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-228-8770
Mailing Address - Street 1:406 LECOMPTE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2437
Mailing Address - Country:US
Mailing Address - Phone:410-228-8770
Mailing Address - Fax:
Practice Address - Street 1:406 LECOMPTE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2437
Practice Address - Country:US
Practice Address - Phone:410-228-8770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental