Individual
DR. KYOUNG HAN BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
116 BROADWAY, MALVERNE, NY 11565-1635
(917) 484-0986
Mailing address
116 BROADWAY, MALVERNE, NY 11565-1635
(917) 484-0986
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
064016
NY
122300000X
Dentist
DN1858395
MA
Other
Enumeration date
07/16/2019
Last updated
02/13/2025
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