Individual
MYUNG-HYUN BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3741 MAIN ST, BRIDGEPORT, CT 06606-3609
(267) 939-0477
Mailing address
101 JACKSON AVE, 4F, MINEOLA, NY 11501-2702
(267) 939-0477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011565
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2015
Last updated
05/17/2016
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