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Organization
MILILANI DENTAL INC.
Active
Organization
MILILANI DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD MATIASEVICH DDS (OWNER/DENTIST)
(808) 366-1097
Entity
Organization
Contact information
Practice address
95-1249 MEHEULA PARKWAY, 138, MILILANI, HI 96789
(808) 625-6223
Mailing address
95-1249 MEHEULA PKWY STE 138, MILILANI, HI 96789-1788
(808) 625-6223
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2481
HI
Other
Enumeration date
08/18/2017
Last updated
06/16/2018
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