Provider Demographics
NPI:1619316296
Name:MORITA, SCOTT LAU (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LAU
Last Name:MORITA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5311
Mailing Address - Country:US
Mailing Address - Phone:808-486-5505
Mailing Address - Fax:808-488-1822
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 325
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-486-5505
Practice Address - Fax:808-488-1822
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI24591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics