Healthcare Provider Details

I. General information

NPI: 1811124142
Provider Name (Legal Business Name): LAURA TAMAYOSE LAWLER, DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 920
HONOLULU HI
96814-4402
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD STE 920
HONOLULU HI
96814-4402
US

V. Phone/Fax

Practice location:
  • Phone: 808-973-3711
  • Fax: 808-973-3707
Mailing address:
  • Phone: 808-973-3711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDT1288
License Number StateHI

VIII. Authorized Official

Name: LAURA TAMAYOSE LAWLER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 808-973-3711