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General NPI Number Information
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NPI Number | 1265816029
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Entity Type | Individual
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Provider Name | LAURA JUJIN CHANG DDS
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Gender | Female
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Dates
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Enumeration Date | 07/11/2015
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Last Update Date | 07/11/2015
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Provider Practice Location Address
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Address Line | 4211 WAIALAE AVE STE 111
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City | HONOLULU
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State | HI
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Zip | 96816-5300
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Country | US
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Telephone | 808-732-4377
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Fax |
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Provider Business Mailing Address
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Address Line | 5324 KALANIANAOLE HWY
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City | HONOLULU
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State | HI
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Zip | 96821-1934
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Country | US
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Telephone | 206-291-8879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2606
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License Number State | HI
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