Individual
ANDREW CHUNGSUP BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
422 MAIN ST, FORT LEE, NJ 07024-2861
(201) 585-1669
(201) 585-2315
Mailing address
422 MAIN ST, FORT LEE, NJ 07024-2861
(201) 585-1669
(201) 585-2315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02256500
NJ
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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