NPI 1083694020

Gary E Prose, DDS

Practitioner General Practice Dentistry Kailua, HI

Practice location

Address: 322 Aoloa St APT 905, Kailua, HI 96734-3041
Phone: (808) 261-0055

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 104980 (CO)

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Registry record

NPI: 1083694020
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jan 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.