Individual
GLENN M OKUMOTO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1700 LANAKILA AVE, HONOLULU, HI 96817
(808) 832-5710
(808) 832-5722
Mailing address
94309 WAIMAKA ST, MILLANI, HI 96789
(808) 625-7062
(808) 832-5722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1024
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06784701
—
HI
Enumeration date
11/10/2005
Last updated
07/08/2007
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