Organization
SWEETWATER DENTAL L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XIAO LI SHELLY HUANG D.D.S. (OWNER - DENTIST)
(808) 947-2929
Entity
Organization
Contact information
Practice address
1136 UNION MALL SUITE 502, HONOLULU, HI 96813
(808) 947-2929
Mailing address
1136 UNION MALL SUITE 502, HONOLULU, HI 96813
(808) 947-2929
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2118
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57533405
—
HI
Enumeration date
03/27/2014
Last updated
03/27/2014
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