Individual
DR. IMELDA CELESTIAL TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1520 LILIHA ST, SUITE 503, HONOLULU, HI 96817-3562
(808) 532-5888
(808) 528-3384
Mailing address
1520 LILIHA ST, SUITE 503, HONOLULU, HI 96817-3562
(808) 532-5888
(808) 528-3384
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT 2088
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208803
HDS
HI
05
—
58234702
—
HI
01
—
C24937-9
HMSA
HI
Enumeration date
03/19/2007
Last updated
07/09/2007
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