Healthcare Provider Details

I. General information

NPI: 1881703825
Provider Name (Legal Business Name): TZU-LAN KUO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD. SUITE 1505
HONOLULU HI
96814-4402
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD. SUITE 1505
HONOLULU HI
96814-4402
US

V. Phone/Fax

Practice location:
  • Phone: 808-951-6888
  • Fax: 808-951-6899
Mailing address:
  • Phone: 808-951-6888
  • Fax: 808-951-6899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDT-1940
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: