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4850 Kapolei Pkwy Ste 304 Kapolei HI 96707-3204 | |
| (808) 202-2092 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4850 Kapolei Pkwy Ste 304, Kapolei, Hawaii |
| Authorized Official Name and Position | Lisa Wh Wong (MANAGER) |
| Authorized Official Contact | 8082022092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
50 S Beretania St Ste C117b Honolulu HI 96813-2287 Ph: (808) 538-6522 | 4850 Kapolei Pkwy Ste 304 Kapolei HI 96707-3204 Ph: (808) 202-2092 |
| NPI Number | 1578910568 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 05/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578910568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2521 (Hawaii) | Primary |
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