=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437407707
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARLON C PARATO DMD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2012
-----------------------------------------------------
Last Update Date | 08/16/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1441 KAPIOLANI BLVD BLDG SUITE917
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-942-5639
-----------------------------------------------------
Fax | 808-949-6480
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1441 KAPIOLANI BLVD BLDG SUITE917
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-942-5639
-----------------------------------------------------
Fax | 808-949-6480
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. MARLON C. PARATO
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 808-942-5639
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DT2003
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------