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General NPI Number Information
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NPI Number | 1235811050
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Entity Type | Organization
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Legal Business Name | SICILIA DENTAL LLC
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 1314 S KING ST STE 510
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City | HONOLULU
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State | HI
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Zip | 96814-1940
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Country | US
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Telephone | 808-593-8476
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 MAKIKI ST APT A
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City | HONOLULU
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State | HI
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Zip | 96822-4520
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Country | US
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Telephone | 215-589-3628
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WILLIAM ROBERT SICILIA
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Credential | DMD
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Telephone | 215-589-3628
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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 |
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License Number State |
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