Organization
JUN TAE BAE, DDS, PA
Active
Other names
Family Dentistry of Laurel
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUN TAE BAE DDS (DOCTOR)
(301) 490-8200
Entity
Organization
Contact information
Practice address
13974 BALTIMORE AVE, LAUREL, MD 20707-5086
(301) 490-8200
(301) 490-4300
Mailing address
13974 BALTIMORE AVE, LAUREL, MD 20707-5086
(301) 490-8200
(301) 490-4300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11589
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013172500
—
MD
Enumeration date
04/13/2011
Last updated
04/13/2011
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