Provider Demographics
NPI:1689849291
Name:SEUNG EUN BAIK, D.D.S., P.C.
Entity Type:Organization
Organization Name:SEUNG EUN BAIK, D.D.S., P.C.
Other - Org Name:OPTIMA DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEUNG EUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-296-9100
Mailing Address - Street 1:9101 N GREENWOOD AVE
Mailing Address - Street 2:SUITE #202
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1499
Mailing Address - Country:US
Mailing Address - Phone:847-296-9100
Mailing Address - Fax:847-296-9101
Practice Address - Street 1:9101 N GREENWOOD AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1499
Practice Address - Country:US
Practice Address - Phone:847-296-9100
Practice Address - Fax:847-296-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026254261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental