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General NPI Number Information
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NPI Number | 1144766486
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Entity Type | Organization
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Legal Business Name | HONU SMILES PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 95-1105 AINAMAKUA DR #202
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City | MILILANI
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State | HI
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Zip | 96789-6313
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Country | US
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Telephone | 206-291-8879
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Fax |
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Provider Business Mailing Address
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Address Line | 95-1105 AINAMAKUA DR #202
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City | MILILANI
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State | HI
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Zip | 96789-6313
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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 | DENTIST
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Name | JOHN WILLIAM CHANG
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Credential | DDS
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Telephone | 808-221-2367
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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 | DT-2543
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License Number State | HI
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