Healthcare Provider Details

I. General information

NPI: 1366675613
Provider Name (Legal Business Name): NORA K. HARMSEN, D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 09/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 LANAI AVENUE SUITE 101
LANAI CITY HI
96763-0069
US

IV. Provider business mailing address

PO BOX 630069
LANAI CITY HI
96763-0069
US

V. Phone/Fax

Practice location:
  • Phone: 808-565-6418
  • Fax: 808-565-6742
Mailing address:
  • Phone: 808-565-6418
  • Fax: 808-565-6742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberDT1969
License Number StateHI

VIII. Authorized Official

Name: DR. NORA K HARMSEN
Title or Position: OWNER
Credential: D.D.S.
Phone: 808-565-6418