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General NPI Number Information
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NPI Number | 1194482562
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Entity Type | Organization
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Legal Business Name | JUST KEIKI DENTAL
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Dates
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Enumeration Date | 11/20/2021
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Last Update Date | 11/20/2021
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Provider Practice Location Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 541-480-0056
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Fax |
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Provider Business Mailing Address
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Address Line | 175 HOANO PL
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City | KIHEI
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State | HI
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Zip | 96753-7910
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Country | US
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Telephone | 541-480-0056
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERICA HOLLANDER
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Credential | DMD
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Telephone | 541-480-0056
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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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