Individual
JORDAN TAKAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
850 KAMEHAMEHA HWY STE 260, PEARL CITY, HI 96782-2690
(808) 456-4555
Mailing address
850 KAMEHAMEHA HWY STE 260, PEARL CITY, HI 96782-2690
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DT2647
HI
1223G0001X
General Practice Dentistry
D9755
OR
Other
Enumeration date
08/01/2012
Last updated
11/18/2020
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