Organization
ISLAND ORAL AND MAXILLOFACIAL SURGERY, L.L.C.
Active
Other names
Island Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW SCOTT ABRAHAM DDS, MD (OWNER)
(808) 674-2255
Entity
Organization
Contact information
Practice address
338 KAMOKILA BLVD STE 203, KAPOLEI, HI 96707-2055
(808) 674-2255
(808) 674-1771
Mailing address
338 KAMOKILA BLVD STE 203, KAPOLEI, HI 96707-2055
(808) 674-2255
(808) 674-1771
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
629694
—
HI
Enumeration date
06/07/2019
Last updated
06/07/2019
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