Organization
MARK Y. SHIMAO, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK YUJI SHIMAO DDS (DENTIST/OWNER)
(808) 689-6900
Entity
Organization
Contact information
Practice address
91-902 FORT WEAVER RD, SUITE 201, EWA BEACH, HI 96706-2261
(808) 689-6900
(808) 689-8330
Mailing address
91-902 FORT WEAVER RD, SUITE 201, EWA BEACH, HI 96706-2261
(808) 689-6900
(808) 689-8330
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1694
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069761 01
—
HI
Enumeration date
09/19/2009
Last updated
09/19/2009
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