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JASON KAOPUA DMD

>> Dentist >> Dental Providers

Registrant NPI Number: 1356304000

Individual Registrant:
 JASON  KAOPUA DMD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
16-192 PILI MUA ST KEAAU FAMILY HEALTH CENTER KEAAU, HI 96749 US
Tel: 808-930-0400  Fax: 808-934-3238

Contact information for business:
311 KALANIANAOLE AVE BAY CLINIC INC HILO, HI 96720 US
Tel: 808-930-0419  Fax: 808-961-5167

Registration Information:
NPI: 1356304000
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
HIDT2042

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
UHA824916HI01
252240HI05
HMSAD217358HI01




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