Healthcare Provider Details

I. General information

NPI: 1407335805
Provider Name (Legal Business Name): ERIK PETTER STROMMER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-150 KAONOHI ST STE C201
AIEA HI
96701-5022
US

IV. Provider business mailing address

500 ALA MOANA BLVD STE 7-220
HONOLULU HI
96813-4900
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-3368
  • Fax: 808-486-5729
Mailing address:
  • Phone: 808-523-3103
  • Fax: 808-523-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDT2762
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: