Individual
MRS. PATTIE LUCAS PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
400 SAND ISLAND ACCESS RD, HONOLULU, HI 96819
(808) 842-2930
Mailing address
91-784 LAUNAHELE ST, EWA BEACH, HI 96706-4755
(808) 685-5520
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3159
HYGIENE LICENSE
NC
Enumeration date
12/22/2006
Last updated
07/08/2007
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