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General NPI Number Information
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NPI Number | 1477680296
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Entity Type | Organization
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Legal Business Name | DAYTON Q.L. LUM, D.D.S., INC.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 850 KAMEHAMEHA HIGHWAY SUITE 155
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City | PEARL CITY
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State | HI
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Zip | 96782-2657
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Country | US
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Telephone | 808-456-5005
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Fax | 808-454-2569
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Provider Business Mailing Address
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Address Line | 850 KAMEHAMEHA HIGHWAY SUITE 155
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City | PEARL CITY
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State | HI
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Zip | 96782-2657
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Country | US
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Telephone | 808-456-5005
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Fax | 808-454-2569
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DAYTON Q.L. LUM
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Credential | D.D.S.
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Telephone | 808-456-5005
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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 | 1314
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License Number State | HI
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