Organization
JI S KIM
Active
Other names
Mauka Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JI S KIM (BUSINESS OWNER)
(808) 291-2487
Entity
Organization
Contact information
Practice address
95-1095 AINAMAKUA DRIVE, SUITE 5/7 A, MILILANI, HI 96789
(808) 797-3044
(808) 797-3042
Mailing address
95-1095 AINAMAKUA DRIVE, SUITE 5/7 A, MILILANI, HI 96789
(808) 797-3044
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740357755
NPI 1
HI
Enumeration date
06/16/2020
Last updated
06/16/2020
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