Organization
ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY LUNG D.M.D. (PRESIDENT)
(808) 973-3747
Entity
Organization
Contact information
Practice address
1580 MAKALOA ST, SUITE 725, HONOLULU, HI 96814
(808) 973-3747
(808) 973-3757
Mailing address
1580 MAKALOA ST, SUITE 725, HONOLULU, HI 96814-3237
(808) 973-3747
(808) 973-3757
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1088
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326130717
INDIVIDUAL NPI
HI
01
—
1689772659
PATNER'S INDIVIDUAL NPI
HI
01
—
HOMS
MEDICARE LEGACY
HI
Enumeration date
05/14/2007
Last updated
09/04/2018
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