MEDICARE: GABRIEL L UY DDS

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	1223G0001X	General Practice Dentistry	1635	HI

General Provider Information

NPI Number	:	1427100494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL L UY DDS

Provider Business Mailing Address
First Line	:	76-6225 KUAKINI HWY
Second Line	:	SUITE A106
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-3212
Country	:	US
Telephone Number	:	808-329-8899
Fax Number	:	808-334-0055

Provider Business Practice Location Address
First Line	:	76-6225 KUAKINI HWY
Second Line	:	SUITE A106
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-3212
Country	:	US
Telephone Number	:	808-329-8899
Fax Number	:	808-334-0055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/08/2007

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