Organization
WEST HAWAII DENTAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY L AULT DDS (PRESIDENT)
(808) 322-9355
Entity
Organization
Contact information
Practice address
81-990 HALEKII ST UNIT 7, KEALAKEKUA, HI 96750-8155
(808) 322-9355
(808) 322-6130
Mailing address
81-990 HALEKII ST UNIT 7, KEALAKEKUA, HI 96750-8155
(808) 322-9355
(808) 322-6130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000597201
—
HI
Enumeration date
05/28/2009
Last updated
05/28/2009
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