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General NPI Number Information
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NPI Number | 1043884794
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Entity Type | Organization
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Legal Business Name | ALOHA DENTAL STUDIO, LLC
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 154 PAPALAUA ST STE 102
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City | LAHAINA
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State | HI
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Zip | 96761-1616
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Country | US
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Telephone | 808-662-3300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1671
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City | LAHAINA
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State | HI
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Zip | 96767-1671
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Country | US
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Telephone | 808-283-7077
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MATTHEW DODSON
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Credential |
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Telephone | 808-283-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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