Individual
JASON JIN SOO BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
46161 WESTLAKE DR STE 200, STERLING, VA 20165-5871
(703) 544-9740
Mailing address
14955 SHADY GROVE RD STE 330, ROCKVILLE, MD 20850-8720
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401414773
VA
Other
Enumeration date
07/03/2007
Last updated
08/16/2021
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