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Organization
LOUDOUN CENTER FOR ORAL SURGERY, PLLC
Active
Organization
LOUDOUN CENTER FOR ORAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON BAE DDS, MD (OWNER/ SURGEON)
(703) 544-9740
Entity
Organization
Contact information
Practice address
46161 WESTLAKE DR STE 200, STERLING, VA 20165-5871
(703) 544-9740
(703) 544-9741
Mailing address
46161 WESTLAKE DR STE 200, STERLING, VA 20165-5871
(703) 544-9740
(703) 544-9741
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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