Individual
JACY YOSHIMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46-001 KAMEHAMEHA HWY STE 418, KANEOHE, HI 96744-3749
(808) 236-0216
Mailing address
45-790 APUAKEA ST, KANEOHE, HI 96744-1708
(808) 226-6707
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT-2691
HI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/11/2016
Last updated
10/09/2021
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