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Organization
EWA BEACH DENTISTS LLC
Active
Organization
EWA BEACH DENTISTS LLC
Active
Other names
Hawaii Dental Clinic Ewa Beach
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA WH WONG DMD (MANAGER)
(808) 308-9720
Entity
Organization
Contact information
Practice address
105 FORT WEAVER ROAD, STE 105, EWA BEACH, HI 96706
(808) 308-9720
Mailing address
1050 QUEEN ST STE 100, HONOLULU, HI 96814-4130
(808) 202-2092
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2521
HI
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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