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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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