Individual
DR. JEREMY MARK HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
45-1144 KAMEHAMEHA HWY STE #301, KANEOHE, HI 96744
(808) 230-8000
Mailing address
45-1144 KAMEHAMEHA HWY STE #301, KANEOHE, HI 96744
(808) 230-8000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DT2297
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03388570
—
NY
05
—
696908
—
HI
Enumeration date
08/28/2007
Last updated
10/30/2012
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