Organization
DR. D.D.ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LEE DEPRY D.O. (C.E.O.)
(808) 497-7672
Entity
Organization
Contact information
Practice address
377 KEAHOLE ST, E 211-D, HONOLULU, HI 96825-3405
(808) 497-7672
Mailing address
PO BOX 25868, HONOLULU, HI 96825-0868
(808) 497-7672
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386731909
INDIVIDUAL NPI
HI
Enumeration date
07/20/2015
Last updated
07/20/2015
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