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Organization
BAEK DENTAL GROUP
Active
Organization
BAEK DENTAL GROUP
Active
Parent organization
RYAN BAEK DENTAL, LLC
Other names
Ryan Baek Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
RYAN BAEK DENTAL, LLC
Authorized official
AERI (KATIE) BAEK (OFFICE MANAGER)
(215) 643-0300
Entity
Organization
Contact information
Practice address
428 PENNSYLVANIA AVE, FORT WASHINGTON, PA 19034-3413
(215) 643-0300
(215) 643-0333
Mailing address
428 PENNSYLVANIA AVE, FORT WASHINGTON, PA 19034-3413
(215) 643-0300
(215) 643-0333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS037069
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101930230
—
PA
Enumeration date
01/14/2015
Last updated
01/14/2015
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