| NPI | 1932675212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BROGAN Ddd Administrator 808-586-5842 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 126800000X Dental Assistant | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |