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General NPI Number Information
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NPI Number | 1124352943
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Entity Type | Organization
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Legal Business Name | LANCE I. TERAMOTO, DDS, INC.
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 4747 KILAUEA AVE STE 101
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City | HONOLULU
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State | HI
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Zip | 96816-5308
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Country | US
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Telephone | 808-737-9882
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Fax | 808-737-9818
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Provider Business Mailing Address
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Address Line | 4747 KILAUEA AVE STE 101
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City | HONOLULU
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State | HI
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Zip | 96816-5308
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Country | US
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Telephone | 808-737-9882
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Fax | 808-737-9818
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LANCE I TERAMOTO
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Credential | D.D.S.
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Telephone | 808-737-9882
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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 | DT1393
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License Number State | HI
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