Provider Demographics
NPI:1336476811
Name:FRANK C. BAUMHOLTZ III, DDS INC
Entity Type:Organization
Organization Name:FRANK C. BAUMHOLTZ III, DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:C,
Authorized Official - Last Name:BAUMHOLTZ
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-487-5596
Mailing Address - Street 1:98-1247 KAAHUMANU ST STE 321
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5301
Mailing Address - Country:US
Mailing Address - Phone:808-487-5596
Mailing Address - Fax:
Practice Address - Street 1:98-1247 KAAHUMANU ST STE 321
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5301
Practice Address - Country:US
Practice Address - Phone:808-487-5596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 10021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty