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Individual

DR. BRYAN M.K. WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1300 PALI HWY, SUITE 211, HONOLULU, HI 96813-2230
(808) 538-1076
(808) 538-1076
Mailing address
1300 PALI HWY, SUITE 211, HONOLULU, HI 96813-2230
(808) 538-1076
(808) 538-1076

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1397
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000469960
HAWAII MEDICAL SERVICE ASSOCIATION
HI
01
1397
HAWAII LICENSE NUMBER
HI
Enumeration date
12/21/2006
Last updated
10/09/2012
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