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General NPI Number Information
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NPI Number | 1649437195
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Entity Type | Organization
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Legal Business Name | SCOTT A WARDWELL D D S INC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 1150 S KING ST STE 601
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City | HONOLULU
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State | HI
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Zip | 96814-1952
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Country | US
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Telephone | 808-946-0713
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Fax | 808-942-2661
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Provider Business Mailing Address
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Address Line | 1150 S KING ST STE 601
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City | HONOLULU
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State | HI
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Zip | 96814-1952
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Country | US
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Telephone | 808-946-0713
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Fax | 808-942-2661
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT A WARDWELL
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Credential | D D S
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Telephone | 808-946-0713
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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 | DDS38942
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DT1848
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License Number State | HI
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