Andrew Chungsup Bae, D.D.S Valid NPI

Individual provider · Dentist · Fort Lee, NJ

NPI

1992859862

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

22DI02256500 (NJ)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-01-22

Last updated

2007-07-08