Organization
WAIKOLOA DENTAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG G FOSTVEDT DDS (DENTIST/OWNER)
(808) 886-0891
Entity
Organization
Contact information
Practice address
69-201 WAIKOLOA BEACH DR STE 2615, WAIKOLOA, HI 96738-5815
(808) 886-0891
(808) 886-0892
Mailing address
69-201 WAIKOLOA BEACH DRIVE # 2615, WAIKOLOA, HI 96738
(808) 886-0891
(808) 886-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT 1606
HI
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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