MEDICARE: MALCOLM M CHOY DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DT-1903	HI

General Provider Information

NPI Number	:	1073914677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MALCOLM M CHOY DDS INC

Provider Business Mailing Address
First Line	:	829 ISENBERG ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96826-2932
Country	:	US
Telephone Number	:	808-988-6919
Fax Number	:	808-200-4456

Provider Business Practice Location Address
First Line	:	829 ISENBERG ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96826-2932
Country	:	US
Telephone Number	:	808-988-6919
Fax Number	:	808-200-4456

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MALCOLM M CHOY
Credential	:
Telephone Number	:	808-988-6919

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	09/15/2014

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