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Individual

BRIAN VONGCHANPHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
810 KILANI AVE, #A, WAHIAWA, HI 96786
(808) 621-8281
Mailing address
59-072 KUMUPALI RD, HALEIWA, HI 96712-9667
(808) 398-4339

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
62912
CA
1223G0001X
General Practice Dentistry
Primary
DT-2695
HI

Other

Enumeration date
09/10/2013
Last updated
07/31/2018
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