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General NPI Number Information
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NPI Number | 1457430472
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Entity Type | Individual
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Provider Name | GREG T HURTADO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 94-1221 KA UKA BLVD SUITE 201
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City | WAIPAHU
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State | HI
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Zip | 96797-6202
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Country | US
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Telephone | 808-678-3000
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Fax | 808-678-0555
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Provider Business Mailing Address
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Address Line | 94-1221 KA UKA BLVD SUITE 201
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City | WAIPAHU
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State | HI
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Zip | 96797-6202
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Country | US
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Telephone | 808-678-3000
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Fax | 808-678-0555
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DT1800
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License Number State | HI
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