Healthcare Provider Details

I. General information

NPI: 1457587735
Provider Name (Legal Business Name): STEVEN K. SUE, D.D.S., M.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2065 S KING ST STE 304
HONOLULU HI
96826-2225
US

IV. Provider business mailing address

2065 S KING ST STE 304
HONOLULU HI
96826-2225
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-8876
  • Fax: 808-949-8878
Mailing address:
  • Phone: 808-949-8876
  • Fax: 808-949-8878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number790
License Number StateHI

VIII. Authorized Official

Name: DR. STEVEN SUE
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 808-949-8876