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General NPI Number Information
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NPI Number | 1326449877
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Entity Type | Organization
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Legal Business Name | PERIODONTICS HAWAII
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 94-300 FARRINGTON HWY D-02
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City | WAIPAHU
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State | HI
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Zip | 96797-2699
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Country | US
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Telephone | 808-728-2911
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Fax |
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Provider Business Mailing Address
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Address Line | 94-300 FARRINGTON HWY D-02
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City | WAIPAHU
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State | HI
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Zip | 96797-2699
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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 | PRESIDENT/OWNER
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Name | DR. AARON JAMES COLBY
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Credential | DDS
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Telephone | 808-728-2911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2261
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License Number State | HI
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