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Individual

DR. TRACE RYAN BAXTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
33 LONO AVE SUITE 370, KAHULUI, HI 96732
(808) 871-6337
(808) 871-8073
Mailing address
33 LONO AVE SUITE 370, KAHULUI, HI 96732
(808) 871-6337
(808) 871-8073

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DT2492
HI
1223G0001X
General Practice Dentistry
DT2492
HI

Other

Enumeration date
07/01/2011
Last updated
06/10/2016
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