| NPI | 1649437195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A WARDWELL President 808-946-0713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: HI DT1848) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS38942) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2023-04-19 |