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Organization

PREMIER DENTAL GROUP HI INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GLENN Y TAKAKI DDS (PRESIDENT)
(808) 487-1554
Entity
Organization

Contact information

Practice address
98-211 PALI MOMI ST, SUITE 737, AIEA, HI 96701-4301
(808) 342-8611
Mailing address
98-211 PALI MOMI ST, SUITE 737, AIEA, HI 96701-4301
(808) 342-8611
(808) 487-1556

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT2107
HI

Other

Enumeration date
02/21/2017
Last updated
02/21/2017
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