Provider Demographics
NPI:1689721243
Name:TSUKAMOTO, ERIC H (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:TSUKAMOTO
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 1:1314 S KING ST STE 420
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1939
Mailing Address - Country:US
Mailing Address - Phone:808-596-0031
Mailing Address - Fax:808-591-8538
Practice Address - Street 1:1314 S KING ST STE 420
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1939
Practice Address - Country:US
Practice Address - Phone:808-596-0031
Practice Address - Fax:808-591-8538
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice