Provider Demographics
NPI:1407909641
Name:TAUDEL, MARY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:TAUDEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2-2514 KAUMUALII HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-8303
Mailing Address - Country:US
Mailing Address - Phone:808-332-9445
Mailing Address - Fax:
Practice Address - Street 1:2-2514 KAUMUALII HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-8303
Practice Address - Country:US
Practice Address - Phone:808-332-9445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-2150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist