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Organization

KONA CENTER OF FACIAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOAN M GRECO DDS (PRESIDENT/OWNER)
(808) 885-9000
Entity
Organization

Contact information

Practice address
65-1230 MAMALAHOA HWY, C10-12, KAMUELA, HI 96743-8318
(808) 885-9000
Mailing address
65-1230 MAMALAHOA HWY, C10-12, KAMUELA, HI 96743-8318
(808) 885-9000

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DT1813
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03442901
HI
01
38042
HAWAII MEDICAL SERVICE ASSOCIATION
HI
Enumeration date
05/21/2009
Last updated
05/21/2009
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