Waikoloa Dental Clinic Inc | |
69-201 Waikoloa Beach Dr Ste 2615 Waikoloa HI 96738-5815 | |
(808) 886-0891 | |
(808) 886-0892 |
Full Name | Waikoloa Dental Clinic Inc |
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Speciality | Dentist - General Practice |
Location | 69-201 Waikoloa Beach Dr Ste 2615, Waikoloa, Hawaii |
Authorized Official Name and Position | Craig G Fostvedt (DENTIST/OWNER) |
Authorized Official Contact | 8088860891 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Waikoloa Dental Clinic Inc 69-201 Waikoloa Beach Drive # 2615 Waikoloa HI 96738 Ph: (808) 886-0891 | Waikoloa Dental Clinic Inc 69-201 Waikoloa Beach Dr Ste 2615 Waikoloa HI 96738-5815 Ph: (808) 886-0891 |
NPI Number | 1003228982 |
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Provider Enumeration Date | 05/27/2014 |
Last Update Date | 05/27/2014 |
Identifier | Type | State | Issuer |
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1003228982 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | DT 1606 (Hawaii) | Primary |