Provider Demographics
NPI:1003902321
Name:PANG, HARRISON JEN HEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:JEN HEE
Last Name:PANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:HARRISON
Other - Middle Name:J H
Other - Last Name:PANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD LLC
Mailing Address - Street 1:99115 AIEA HEIGHTS DRIVE
Mailing Address - Street 2:AIEA SHOPPING CENTRE SUITE 224
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3974
Mailing Address - Country:US
Mailing Address - Phone:808-486-4044
Mailing Address - Fax:808-486-4044
Practice Address - Street 1:99115 AIEA HEIGHTS DRIVE
Practice Address - Street 2:AIEA SHOPPING CENTRE SUITE 224
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3974
Practice Address - Country:US
Practice Address - Phone:808-486-4044
Practice Address - Fax:808-486-4044
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT1746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist