Dept. of Health-Hi Developmental Disabilities H&cdsb (dental)

NPI #1932675212 in Honolulu, Hawaii

Provider Information

NPI Number: 1932675212
Entity Type: Organization
Organization Name: Dept. of Health-Hi Developmental Disabilities H&cdsb (dental)
Subpart: Yes (part of a larger organization)
Parent Organization: STATE OF HAWAII, DEPARTMENT OF HEALTH
Primary Specialty: Dentist - Dental Public Health
Enumeration Date: Oct 15, 2018
Last Updated: Oct 15, 2018

Practice Location

Address: 1700 LANAKILA AVE RM 203
City: Honolulu
State: Hawaii
ZIP Code: 96817-2115
Phone: (808) 832-5710

Authorized Official

Name: MARY BROGAN
Title: DDD ADMINISTRATOR
Phone: (808) 586-5842

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X
Dental Assistant	126800000X
Dentist - Dental Public Health — Dental Public Health	1223D0001X	Primary

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