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General NPI Number Information
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NPI Number | 1790917417
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Entity Type | Organization
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Legal Business Name | CASEY TAMASHIRO DDS, INC
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 08/13/2009
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Provider Practice Location Address
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Address Line | 1728 WILI PA LOOP STE 100
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City | WAILUKU
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State | HI
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Zip | 96793-1284
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Country | US
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Telephone | 808-244-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1728 WILI PA LOOP STE 100
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City | WAILUKU
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State | HI
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Zip | 96793-1284
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Country | US
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Telephone | 808-244-6000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CASEY TAMASHIRO
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Credential |
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Telephone | 808-244-6000
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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 | DT1743
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License Number State | HI
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