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General NPI Number Information
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NPI Number | 1588770697
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Entity Type | Organization
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Legal Business Name | DENTAL FITNESS INC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 94-673 KUPUOHI STREET SUITE C101
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City | WAIPAHU
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State | HI
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Zip | 96797-1124
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Country | US
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Telephone | 808-677-5588
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Fax | 808-677-6588
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Provider Business Mailing Address
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Address Line | 94-673 KUPUOHI STREET SUITE C101
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City | WAIPAHU
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State | HI
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Zip | 96797-1124
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Country | US
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Telephone | 808-677-5588
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Fax | 808-677-6588
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDITH CABUGON OAMIL-PACHO
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Credential | DMD
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Telephone | 808-677-5588
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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 |
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License Number State |
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