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General NPI Number Information
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NPI Number | 1609213255
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Entity Type | Organization
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Legal Business Name | HONOLULU SMILES
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD STE 1304
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 808-955-0004
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Fax | 808-949-3204
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Provider Business Mailing Address
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Address Line | 1441 KAPIOLANI BLVD STE 1304
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 808-955-0004
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Fax | 808-949-3204
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Authorized Official
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Title or Position | OWNER
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Name | DR. TODD E. GOODE
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Credential | D.D.S.
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Telephone | 808-955-0004
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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 | 1933
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License Number State | HI
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