Provider Demographics
NPI:1134336654
Name:BAEK, PAUL WOOJONG (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WOOJONG
Last Name:BAEK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1284 BEACON ST APT 503
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3728
Mailing Address - Country:US
Mailing Address - Phone:617-276-7692
Mailing Address - Fax:617-696-1688
Practice Address - Street 1:1400 CENTRE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2454
Practice Address - Country:US
Practice Address - Phone:617-630-2828
Practice Address - Fax:617-213-5472
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2015-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA209381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice