| Waikoloa Dental Clinic Inc | |
|
69-201 Waikoloa Beach Dr Ste 2615 Waikoloa HI 96738-5815 | |
| (808) 886-0891 | |
| (808) 886-0892 |
| Full Name | Waikoloa Dental Clinic Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 69-201 Waikoloa Beach Dr Ste 2615, Waikoloa, Hawaii |
| Authorized Official Name and Position | Craig G Fostvedt (DENTIST/OWNER) |
| Authorized Official Contact | 8088860891 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waikoloa Dental Clinic Inc 69-201 Waikoloa Beach Drive # 2615 Waikoloa HI 96738 Ph: (808) 886-0891 | Waikoloa Dental Clinic Inc 69-201 Waikoloa Beach Dr Ste 2615 Waikoloa HI 96738-5815 Ph: (808) 886-0891 |
| NPI Number | 1003228982 |
|---|---|
| Provider Enumeration Date | 05/27/2014 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003228982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DT 1606 (Hawaii) | Primary |
Hawaii Dental Group, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 68-1845 Waikoloa Rd, Suite 205, Waikoloa, HI 96738 Phone: 808-883-9100 Fax: 808-883-1469 |