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General NPI Number Information
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NPI Number | 1023018033
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Entity Type | Individual
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Provider Name | JUDY QUENGUA-BONDOCOY D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 94-300 FARRINGTON HWY G-16
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City | WAIPAHU
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State | HI
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Zip | 96797-2648
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Country | US
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Telephone | 808-680-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 91-277 KAIELEELE PL
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City | EWA BEACH
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State | HI
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Zip | 96706-4617
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Country | US
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Telephone | 808-685-8175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DT-1968
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License Number State | HI
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