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General NPI Number Information
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NPI Number | 1336405091
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Entity Type | Organization
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Legal Business Name | KEN M YAMASHIRO DDS INC
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 04/06/2012
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Provider Practice Location Address
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Address Line | 1142 KINOOLE ST
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City | HILO
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State | HI
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Zip | 96720-4132
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Country | US
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Telephone | 808-961-3911
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Fax | 808-933-9293
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Provider Business Mailing Address
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Address Line | 1142 KINOOLE ST
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City | HILO
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State | HI
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Zip | 96720-4132
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Country | US
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Telephone | 808-961-3911
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Fax | 808-933-9293
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Authorized Official
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Title or Position | PRESIDENT, TREASURER
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Name | DR. KEN YAMASHIRO
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Credential | BA, DDS
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Telephone | 808-961-3911
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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 |
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License Number State |
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