# EWA BEACH DENTISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hawaii Dental Clinic Ewa Beach
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598251894
- **Authorized official:** DR. LISA WH WONG DMD (MANAGER)
- **Authorized official phone:** (808) 308-9720

## Contact information

- **Practice address:** 105 FORT WEAVER ROAD, STE 105, EWA BEACH, HI 96706
- **Practice address phone:** (808) 308-9720
- **Mailing address:** 1050 QUEEN ST STE 100, HONOLULU, HI 96814-4130
- **Mailing address phone:** (808) 202-2092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 2521 | HI | Yes |

## Other

- **Enumeration date:** 07/10/2018
- **Last updated:** 07/10/2018