Organization
KUHIO DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN WILLIAM MAH D.D.S. (OWNER)
(808) 959-3433
Entity
Organization
Contact information
Practice address
111 E PUAINAKO ST UNIT 104, HILO, HI 96720-5288
(808) 959-3433
(808) 959-3675
Mailing address
111 E. PUAINAKO ST.,, UNIT #104, HILO, HI 96720
(808) 959-3433
(808) 959-3675
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DT 1617
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00L063804
HAWAII MEDICAL SERVICES ASSOCIATION
HI
05
—
537730
—
HI
01
—
61617
HAWAII DENTAL SERVICES
HI
Enumeration date
08/06/2009
Last updated
08/06/2009
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