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General NPI Number Information
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NPI Number | 1598997470
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Entity Type | Organization
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Legal Business Name | GARY K. MORITA D.D.S. INC.
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 30 AULIKE ST STE 202
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City | KAILUA
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State | HI
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Zip | 96734-2750
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Country | US
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Telephone | 808-262-8227
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Fax |
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Provider Business Mailing Address
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Address Line | 30 AULIKE ST STE 202
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City | KAILUA
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State | HI
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Zip | 96734-2750
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Country | US
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Telephone | 808-262-8227
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GARY K MORITA
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Credential | D.D.S.
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Telephone | 808-262-8227
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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 | DT-780
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License Number State | HI
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