Individual
DR. JONATHAN WILLIAM MAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
111 E PUAINAKO ST, STE. A-104, HILO, HI 96720-5288
(808) 959-3433
(808) 959-3675
Mailing address
949 IKENA CIR, HONOLULU, HI 96821-2555
(808) 741-3225
(808) 959-3675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT 1617
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055406-02
—
HI
01
—
1672867
UNITED CONCORDIA
HI
01
—
61617
HAWAII DENTAL SERVICE
HI
01
—
L06380-4
HMSA
HI
Enumeration date
07/31/2006
Last updated
07/08/2007
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