Individual
MADALYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1257 KILAUEA AVE, SUITE 100, HILO, HI 96720-4205
(808) 333-3600
Mailing address
45 AIPUNI ST, HILO, HI 96720-1801
(417) 529-6406
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/10/2016
Last updated
03/29/2017
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