| NPI | 1275336224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE MATHSON Director Of Business Development 808-430-0388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-03-27 |