Organization
WINDWARD PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YANGSUN BAK DDS (PRESIDENT)
(770) 344-0170
Entity
Organization
Contact information
Practice address
11730 JONES BRIDGE RD, STE B, C, & D, ALPHARETTA, GA 30005-5077
(770) 344-0170
(770) 344-0169
Mailing address
11730 JONES BRIDGE RD, STE B, C, & D, ALPHARETTA, GA 30005-5077
(770) 344-0170
(770) 344-0169
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN012678
GA
1223P0221X
Pediatric Dentistry
DN012679
GA
Other
Enumeration date
01/29/2007
Last updated
08/22/2020
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