| Susan Bae, Dds, Ms, Inc. | |
|
10945 South St Ste 202a Cerritos CA 90703-5366 | |
| (424) 256-3967 | |
| Not Available |
| Full Name | Susan Bae, Dds, Ms, Inc. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 10945 South St Ste 202a, Cerritos, California |
| Authorized Official Name and Position | Susan Bae (CEO) |
| Authorized Official Contact | 4242563967 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Bae, Dds, Ms, Inc. 325 N Larchmont Blvd Ste 127 Los Angeles CA 90004-3011 Ph: () - | Susan Bae, Dds, Ms, Inc. 10945 South St Ste 202a Cerritos CA 90703-5366 Ph: (424) 256-3967 |
| NPI Number | 1780179176 |
|---|---|
| Provider Enumeration Date | 06/27/2018 |
| Last Update Date | 07/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780179176 | NPI | - | NPPES |
| 100794 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 100794 (California) | Primary |
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