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General NPI Number Information
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NPI Number | 1528107703
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Entity Type | Individual
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Provider Name | ANDREW CUSTODIO DADO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 930 VALKENBURGH ST STE. 209
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City | HONOLULU
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State | HI
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Zip | 96818-3912
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Country | US
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Telephone | 808-422-2112
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Fax |
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Provider Business Mailing Address
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Address Line | 590 FARRINGTON HWY UNIT 524 166
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City | KAPOLEI
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State | HI
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Zip | 96707-2034
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Country | US
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Telephone | 805-377-1274
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Fax |
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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 | 1989
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License Number State | HI
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