Individual
DR. MARK K. KOIZUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
275 PONAHAWAI ST, STE.103, HILO, HI 96720-3074
(808) 935-1149
Mailing address
275 PONAHAWAI ST, STE.103, HILO, HI 96720-3074
(808) 935-1149
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT-1380
HI
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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