Organization
WAILUKU DENTAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN K LAU D.D.S. (OWNER)
(808) 244-8808
Entity
Organization
Contact information
Practice address
255 IMI KALA ST, WAILUKU, HI 96793-1282
(808) 244-8808
(808) 244-6032
Mailing address
255 IMI KALA ST, WAILUKU, HI 96793-1282
(808) 244-8808
(808) 244-6032
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1388
HI
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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