# EMERALD ISLAND ORAL FACIAL SURGERY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710199054
- **Authorized official:** DR. DAVID H. RUSSELL D.M.D. (PRESIDENT)
- **Authorized official phone:** (808) 245-9339

## Contact information

- **Practice address:** 4414 KUKUI GROVE ST, SUITE \#103, LIHUE, HI 96766-2016
- **Practice address phone:** (808) 245-9339
- **Mailing address:** 4381 KUKUI GROVE ST UNIT 101, LIHUE, HI 96766-1639
- **Mailing address phone:** (808) 245-9339
- **Mailing address fax:** (808) 246-9242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DT1886 | HI | Yes |

## Other

- **Enumeration date:** 05/07/2007
- **Last updated:** 06/25/2024