Individual
DR. BRADLEY THOMAS-TERROLL HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
95-390 KUAHELANI, 3AC-1193, MILILANI, HI 96789-1192
(808) 201-9273
Mailing address
95-390 KUAHELANI, 3AC-1193, MILILANI, HI 96789-1192
(808) 201-9273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
17143
MD
1223G0001X
General Practice Dentistry
Primary
DT-2880-0
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15743316
CAQH ID
—
05
—
265063100
—
MD
Enumeration date
09/16/2019
Last updated
11/26/2022
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