Provider Demographics
NPI:1023018033
Name:QUENGUA-BONDOCOY, JUDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:QUENGUA-BONDOCOY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-277 KAIELEELE PL
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4617
Mailing Address - Country:US
Mailing Address - Phone:808-685-8175
Mailing Address - Fax:
Practice Address - Street 1:94-300 FARRINGTON HWY
Practice Address - Street 2:G-16
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2648
Practice Address - Country:US
Practice Address - Phone:808-680-7800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-19681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice