Organization
CONRAD C THEISS DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONRAD C THEISS (PERIODONTIST)
(808) 877-3605
Entity
Organization
Contact information
Practice address
33 LONO AVE SUITE 210, KAHULUI, HI 96732
(808) 877-3605
Mailing address
33 LONO AVE STE 210, KAHULUI, HI 96732-1632
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DT0971
GU
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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