Healthcare Provider Details

I. General information

NPI: 1851531560
Provider Name (Legal Business Name): OMURA & INOUYE, D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S KING ST SUITE 305
HONOLULU HI
96814-1922
US

IV. Provider business mailing address

1150 S KING ST SUITE 305
HONOLULU HI
96814-1922
US

V. Phone/Fax

Practice location:
  • Phone: 808-593-2999
  • Fax:
Mailing address:
  • Phone: 808-593-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1185
License Number StateHI

VIII. Authorized Official

Name: DR. GLENN M INOUYE
Title or Position: OWNER
Credential: D.D.S.
Phone: 808-593-2999