Individual
NICHOLAS DELISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
74-5214 KKEANALEHU DR, KAILUA-KONA, HI 96740
(808) 353-5650
Mailing address
4800 4TH WAY SW, OLYMPIA, WA 98502-2683
(702) 624-5850
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3084
HI
Other
Enumeration date
06/17/2016
Last updated
08/17/2023
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