Individual
DR. GLENN MAMO BIVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
98211 PALI MOMI ST, #412, AIEA, HI 96701-4318
(808) 488-0822
Mailing address
98211 PALI MOMI ST, #412, AIEA, HI 96701
(808) 488-0822
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
673
HI
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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