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General NPI Number Information
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NPI Number | 1669268090
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Entity Type | Organization
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Legal Business Name | BROOKS DENTAL LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 65-1279 KAWAIHAE RD STE 101
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City | KAMUELA
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State | HI
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Zip | 96743-8444
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Country | US
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Telephone | 808-885-8617
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Fax |
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Provider Business Mailing Address
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Address Line | 68-1874 LINA POEPOE ST
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City | WAIKOLOA
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State | HI
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Zip | 96738-5421
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Country | US
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Telephone | 480-560-6960
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM T. BROOKS III
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Credential | DMD
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Telephone | 480-560-6960
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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 |
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License Number State |
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