Individual
JULIE T. TANABE GOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3538 WAIALAE AVE STE 206, HONOLULU, HI 96816-2742
(808) 734-8969
(808) 737-2634
Mailing address
3538 WAIALAE AVE STE 206, HONOLULU, HI 96816-2742
(808) 734-8969
(808) 737-2634
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT-1891
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891
HDS PROVIDER NO.
HI
01
—
208538
HMSA PROVIDER NO.
HI
01
—
DT 1891
STATE DENTIST LICENSE NO.
HI
Enumeration date
10/26/2006
Last updated
07/08/2007
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