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Individual

DR. JUSTIN CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
65-1230 MAMALAHOA HWY STE A21, KAMUELA, HI 96743-7317
(808) 885-8465
Mailing address
65-1230 MAMALAHOA HWY STE A21, KAMUELA, HI 96743-7317
(586) 556-0220

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2901600517
MI
1223G0001X
General Practice Dentistry
Primary
DT-3140
HI

Other

Enumeration date
06/20/2020
Last updated
03/25/2025
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