Provider Demographics
NPI:1700963949
Name:PYON, HAK RAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAK
Middle Name:RAE
Last Name:PYON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 LAWRENCEVILLE SUWANEE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6569
Mailing Address - Country:US
Mailing Address - Phone:770-409-9918
Mailing Address - Fax:770-904-6823
Practice Address - Street 1:3370 LAWRENCEVILLE SUWANEE RD STE 106
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6569
Practice Address - Country:US
Practice Address - Phone:770-904-6786
Practice Address - Fax:770-904-6786
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0132841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice