Individual
DR. RANDALL P JAUREQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4370 KUKUI GROVE ST, SUITE 211, LIHUE, HI 96766-2001
(808) 245-8866
(808) 246-0698
Mailing address
4370 KUKUI GROVE ST, SUITE 211, LIHUE, HI 96766-2001
(808) 245-8866
(808) 246-0698
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2009
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50514101
—
HI
Enumeration date
12/12/2006
Last updated
08/01/2014
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