Provider Demographics
NPI:1245033000
Name:BAN & CHAE DMD P.C.
Entity type:Organization
Organization Name:BAN & CHAE DMD P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYEONG
Authorized Official - Middle Name:HYUN
Authorized Official - Last Name:CHAE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-206-2842
Mailing Address - Street 1:56 MEADOWBROOK LN # 56
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1712
Mailing Address - Country:US
Mailing Address - Phone:267-206-2842
Mailing Address - Fax:
Practice Address - Street 1:173 AVENUE A
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1212
Practice Address - Country:US
Practice Address - Phone:413-863-2296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty