Individual
RICHARD GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4800 KAWAIHAU RD STE D, KAPAA, HI 96746-1964
(808) 240-0180
(808) 822-9298
Mailing address
PO BOX 3990, LIHUE, HI 96766
(808) 240-0100
(808) 245-8867
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
CSDT-16
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000258202
HMSA EAST
HI
05
—
523979-02
—
HI
01
—
CDST-16
HDS
HI
Enumeration date
12/16/2006
Last updated
07/09/2007
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