Organization
ANCHETA PEDIATRIC DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANEL ANCHETA-CARROLL D.M.D. (OWNER/PEDIATRIC DENTIST)
(808) 561-2054
Entity
Organization
Contact information
Practice address
98-1247 KAAHUMANU ST, SUITE 205, AIEA, HI 96701-5311
(808) 487-1009
(808) 487-1004
Mailing address
98-1247 KAAHUMANU ST, SUITE 205, AIEA, HI 96701-5311
(808) 487-1009
(808) 487-1004
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DT-2079
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
574857-03
—
HI
Enumeration date
03/01/2017
Last updated
03/01/2017
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