Individual
KIMBERLY AMANDA KANESHIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
667 N MARINE CORPS DR STE 204, TAMUNING, GU 96913-4429
(671) 646-3679
Mailing address
PO BOX 26409, BARRIGADA, GU 96921-6409
(671) 683-8022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0442000414
VA
122300000X
Dentist
Primary
D1043
GU
Other
Enumeration date
08/04/2020
Last updated
09/14/2021
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