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General NPI Number Information
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NPI Number | 1629946645
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Entity Type | Organization
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Legal Business Name | WHITE SMILE DENTISTRY
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 2730 PEACHTREE INDUSTRIAL BLVD STE 202
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City | DULUTH
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State | GA
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Zip | 30097-8628
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Country | US
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Telephone | 404-666-5746
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Fax |
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Provider Business Mailing Address
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Address Line | 2730 PEACHTREE INDUSTRIAL BLVD STE 202
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City | DULUTH
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State | GA
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Zip | 30097-8628
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Country | US
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Telephone | 470-222-4995
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. KYUNGTAEK BAEK
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Credential | DMD
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Telephone | 404-717-9341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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