Provider Demographics
NPI:1851451454
Name:BAK, YANG-SUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:YANG-SUN
Middle Name:
Last Name:BAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11730 JONES BRIDGE RD
Mailing Address - Street 2:STE. B, C, & D
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5077
Mailing Address - Country:US
Mailing Address - Phone:770-344-0170
Mailing Address - Fax:770-344-0169
Practice Address - Street 1:11730 JONES BRIDGE RD
Practice Address - Street 2:STE. B, C, & D
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5077
Practice Address - Country:US
Practice Address - Phone:770-344-0170
Practice Address - Fax:770-344-0169
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0126781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry