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General NPI Number Information
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NPI Number | 1245301134
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Entity Type | Organization
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Legal Business Name | PEARL FAMILY DENTAL CARE, INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 930 VALKENBURGH ST UNIT 209
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City | HONOLULU
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State | HI
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Zip | 96818-3914
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Country | US
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Telephone | 808-422-2112
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Fax | 808-422-2110
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Provider Business Mailing Address
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Address Line | 930 VALKENBURGH ST UNIT 209
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City | HONOLULU
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State | HI
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Zip | 96818-3914
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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 | CREDENTIALING SPECIALIST
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Name | ASHLY SUNSHINE
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Credential |
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Telephone | 314-413-2803
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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 | DT-1398
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License Number State | HI
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