Individual
DR. RANDALL TOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1811A WILI PA LOOP, WAILUKU, HI 96793-1273
(808) 244-0055
Mailing address
1811A WILI PA LOOP, WAILUKU, HI 96793-1273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1425
HI
Other
Enumeration date
07/04/2007
Last updated
07/08/2007
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