Individual
LEEANN BAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
421 HIGGINS AVE, BRIELLE, NJ 08730-1413
(732) 528-6336
Mailing address
421 HIGGINS AVE, BRIELLE, NJ 08730-1413
(732) 528-6336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02911300
NJ
Other
Enumeration date
03/29/2022
Last updated
09/21/2023
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