Healthcare Provider Details

I. General information

NPI: 1437298619
Provider Name (Legal Business Name): MANUEL KUM TONG KAU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 CALIFORNIA AVE STE 204
WAHIAWA HI
96786-1841
US

IV. Provider business mailing address

1841 WILDER AVE
HONOLULU HI
96822-3348
US

V. Phone/Fax

Practice location:
  • Phone: 808-622-2633
  • Fax: 808-622-2342
Mailing address:
  • Phone: 808-942-8521
  • Fax: 808-942-8521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1311
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: