Healthcare Provider Details

I. General information

NPI: 1891021796
Provider Name (Legal Business Name): ALA MOANA DENTAL GROUP OB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD #706
HONOLULU HI
96814-4402
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD #706
HONOLULU HI
96814-4402
US

V. Phone/Fax

Practice location:
  • Phone: 808-946-0944
  • Fax: 808-949-1522
Mailing address:
  • Phone: 808-946-0944
  • Fax: 808-949-1522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number82801
License Number StateHI

VIII. Authorized Official

Name: DR. VICTOR H. ZUERCHER JR.
Title or Position: DENTIST
Credential: D.D.S.
Phone: 808-946-0944