Provider Demographics
NPI:1609998368
Name:TEMPLE VALLEY DENTAL CARE INC
Entity Type:Organization
Organization Name:TEMPLE VALLEY DENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CATOBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-239-6711
Mailing Address - Street 1:47 388 HUI IWA ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744
Mailing Address - Country:US
Mailing Address - Phone:808-239-6711
Mailing Address - Fax:808-239-6706
Practice Address - Street 1:47 388 HUI IWA ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744
Practice Address - Country:US
Practice Address - Phone:808-239-6711
Practice Address - Fax:808-239-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI891122300000X
HI1073122300000X
HI2100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty