Individual
SUSAN TATEISHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
755 SCOTT CIR STE 559, HICKAM AFB, HI 96853-5399
(808) 448-6310
Mailing address
95-1102 AUINA ST, MILILANI, HI 96789-4847
(808) 448-6310
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
647
HI
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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