Provider Demographics
NPI:1326182734
Name:OGAWA, ROBERT N JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:OGAWA
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PAUAHI ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3067
Mailing Address - Country:US
Mailing Address - Phone:808-935-0911
Mailing Address - Fax:808-935-0911
Practice Address - Street 1:120 PAUAHI ST
Practice Address - Street 2:SUITE 304
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3067
Practice Address - Country:US
Practice Address - Phone:808-935-0911
Practice Address - Fax:808-935-0911
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice