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General NPI Number Information
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NPI Number | 1851663033
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Entity Type | Organization
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Legal Business Name | ALA MOANA DENTAL CARE, INC.
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1601 KAPIOLANI BLVD #101
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City | HONOLULU
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State | HI
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Zip | 96814-4704
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Country | US
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Telephone | 808-941-5555
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Fax | 808-947-2333
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Provider Business Mailing Address
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Address Line | 1601 KAPIOLANI BLVD #101
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City | HONOLULU
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State | HI
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Zip | 96814-4704
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Country | US
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Telephone | 808-941-5555
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Fax | 808-947-2333
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Authorized Official
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Title or Position | FINANCIAL/INSURANCE MANAGER
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Name | MS. JACQUELINE A CLOUTIER
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Credential |
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Telephone | 808-941-5555
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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 | HI
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