Premier Dental Group Hi INC

NPI #1407395668 in Aiea, Hawaii

Provider Information

NPI Number: 1407395668
Entity Type: Organization
Organization Name: Premier Dental Group Hi INC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 21, 2017
Last Updated: Feb 21, 2017

Practice Location

Address: 98-211 PALI MOMI ST
Address 2: SUITE 737
City: Aiea
State: Hawaii
ZIP Code: 96701-4301
Phone: (808) 342-8611

Authorized Official

Name: DR. GLENN Y TAKAKI, DDS
Title: PRESIDENT
Phone: (808) 487-1554

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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