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General NPI Number Information
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NPI Number | 1538295027
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Entity Type | Organization
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Legal Business Name | MARK TASAKI DDS MS PHD INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 725 KAPIOLANI BLVD SUITE C 102
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 808-596-0000
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Fax | 808-596-0771
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Provider Business Mailing Address
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Address Line | 725 KAPIOLANI BLVD SUITE C 102
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 808-596-0000
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Fax | 808-596-0771
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK MAKOTO TASAKI
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Credential | DDS MS PHD INC
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Telephone | 808-596-0000
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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 | DT1670
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License Number State | HI
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