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Individual

FRED C GAETA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA DDS

Contact information

Practice address
75-5706 HANAMA PL, SUITE 105A, KAILUA KONA, HI 96740-1745
(808) 329-3314
(808) 329-1354
Mailing address
75-5706 HANAMA PL, SUITE 105A, KAILUA KONA, HI 96740-1745
(808) 329-3314
(808) 329-1354

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1156
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1938
HDS
HI
01
J29007
HMSA
HI
Enumeration date
09/26/2006
Last updated
07/08/2007
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