| NPI | 1598482614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY THOMAS-TERROLL HAWKINS General Dentist/President 808-201-9273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-10-20 |
| Last Update Date | 2023-01-18 |