Provider Demographics
NPI:1174663959
Name:HAWAII ORAL & MAXILLOFACIAL SURGERY INC
Entity Type:Organization
Organization Name:HAWAII ORAL & MAXILLOFACIAL SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-973-3700
Mailing Address - Street 1:1441 KAPIOLANI BOULEVARD
Mailing Address - Street 2:SUITE 920
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-973-3700
Mailing Address - Fax:808-973-3707
Practice Address - Street 1:1441 KAPIOLANI BOULEVARD
Practice Address - Street 2:SUITE 920
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-973-3700
Practice Address - Fax:808-973-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT14881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty