Provider Demographics
NPI:1407005457
Name:LESLIE W. S. AU DDS INC
Entity Type:Organization
Organization Name:LESLIE W. S. AU DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:WS
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-323-3343
Mailing Address - Street 1:P.O. BOX 130
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-0130
Mailing Address - Country:US
Mailing Address - Phone:808-323-3343
Mailing Address - Fax:808-323-3343
Practice Address - Street 1:81-6592A MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-0130
Practice Address - Country:US
Practice Address - Phone:808-323-3343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty