Organization
PERIODONTICS, A PROF. CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL WILLIAM AH MOO D.D.S., M.S. (OWNER)
(808) 373-9404
Entity
Organization
Contact information
Practice address
4211 WAIALAE AVE., SUITE 401, HONOLULU, HI 96816
(808) 732-2224
Mailing address
4211 WAIALAE AVE., SUITE 401, HONOLULU, HI 96816
(808) 732-2224
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
641
HI
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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