Provider Demographics
NPI:1548239650
Name:WEE, GORDON DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:DEAN
Last Name:WEE
Suffix:
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 1:94-1036 WAIPIO UKA ST
Mailing Address - Street 2:#107
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4084
Mailing Address - Country:US
Mailing Address - Phone:808-671-0564
Mailing Address - Fax:808-671-0564
Practice Address - Street 1:94-1036 WAIPIO UKA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4050
Practice Address - Country:US
Practice Address - Phone:808-671-0564
Practice Address - Fax:808-671-0564
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-13941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice