Organization
FAMILY DENTAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA PORMENTO ADORA D.M.D. (GENERAL DENTISTRY)
(808) 847-1225
Entity
Organization
Contact information
Practice address
1210 DILLINGHAM BLVD, SUITE 12, HONOLULU, HI 96817-4436
(808) 847-1225
(808) 847-1226
Mailing address
1210 DILLINGHAM BLVD, SUITE 12, HONOLULU, HI 96817-4436
(808) 847-1225
(808) 847-1226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT1882
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07806601
—
HI
01
—
1882
HDS
HI
01
—
859012
UNITED CONCORDIA CO.,INC.
HI
01
—
K0206603
HMSA
HI
Enumeration date
01/16/2007
Last updated
08/22/2020
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