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General NPI Number Information
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NPI Number | 1598094047
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Entity Type | Individual
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Provider Name | MAILE S.C. KIM DDS
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Gender | Female
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 642 ULUKAHIKI ST STE 308
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City | KAILUA
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State | HI
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Zip | 96734-4439
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Country | US
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Telephone | 808-261-5354
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Fax |
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Provider Business Mailing Address
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Address Line | 34 KAAPUNI DR
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City | KAILUA
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State | HI
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Zip | 96734-2322
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Country | US
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Telephone | 808-262-8557
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2159
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License Number State | HI
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