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General NPI Number Information
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NPI Number | 1023687324
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Entity Type | Individual
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Provider Name | JESSICA ROSE VO DMD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2021
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 98-1268 KAAHUMANU ST
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City | PEARL CITY
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State | HI
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Zip | 96782-3257
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Country | US
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Telephone | 808-486-4746
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 DATE ST APT 2103
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City | HONOLULU
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State | HI
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Zip | 96826-5413
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Country | US
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Telephone | 808-693-5824
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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-2909
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DT-2909
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License Number State | HI
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