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General NPI Number Information
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NPI Number | 1538641337
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Entity Type | Organization
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Legal Business Name | DUMBRIQUE DENTAL CLINIC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 94-366 PUPUPANI ST STE 205
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City | WAIPAHU
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State | HI
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Zip | 96797-2644
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Country | US
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Telephone | 808-676-2435
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Fax | 808-671-4568
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Provider Business Mailing Address
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Address Line | 94-366 PUPUPANI ST STE 205
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City | WAIPAHU
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State | HI
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Zip | 96797-2644
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Country | US
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Telephone | 808-676-2435
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Fax | 808-671-4568
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CELIA A. DUMBRIQUE
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Credential | DMD
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Telephone | 808-676-2435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2085
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License Number State | HI
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