| NPI | 1972745974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOHA T THAI Receiptionist 808-591-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |