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General NPI Number Information
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NPI Number | 1134962020
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Entity Type | Organization
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Legal Business Name | SPENCER KIM HOSPITAL DENTISTRY
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 555 SOUTH ST APT 3709
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City | HONOLULU
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State | HI
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Zip | 96813-6228
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Country | US
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Telephone | 808-384-2707
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 283126
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City | HONOLULU
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State | HI
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Zip | 96828-3126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SPENCER KIM
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Credential | DDS
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Telephone | 808-384-2707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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