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General NPI Number Information
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NPI Number | 1649351396
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Entity Type | Individual
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Provider Name | RONALD B QUADE DDS
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | KEAAU FAMILY HEALTH CENTER 16-192 PILIMUA STREET
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City | KEAAU
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State | HI
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Zip | 96749
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Country | US
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Telephone | 808-930-0400
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Fax | 808-930-0438
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Provider Business Mailing Address
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Address Line | KEAAU FAMILY HEALTH CENTER 16-192 PILIMUA STREET
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City | KEAAU
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State | HI
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Zip | 96749
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Country | US
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Telephone | 808-930-0400
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Fax | 808-930-0438
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | CSDT-18
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License Number State | HI
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