Individual
MINKYUNG BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1094 ELDEN ST, HERNDON, VA 20170-3803
(703) 787-2273
Mailing address
1094 ELDEN ST, HERNDON, VA 20170-3803
(847) 704-0741
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417607
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2021
Last updated
12/09/2024
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