Provider Demographics
NPI:1902968506
Name:BAEK, ORSON YOUNG (DDS MS)
Entity type:Individual
Prefix:DR
First Name:ORSON
Middle Name:YOUNG
Last Name:BAEK
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:1650 OAKBROOK DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:NORCORSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093
Mailing Address - Country:US
Mailing Address - Phone:770-446-8000
Mailing Address - Fax:770-446-8000
Practice Address - Street 1:6060 MCDONOUGH DR
Practice Address - Street 2:SUITE I
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093
Practice Address - Country:US
Practice Address - Phone:770-448-3030
Practice Address - Fax:770-447-4906
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0132961223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics