Provider Demographics
NPI:1689875437
Name:ARUCAN MASUNAGA, MILDRED SUSAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:SUSAN
Last Name:ARUCAN MASUNAGA
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 1:960 CENTER STREET
Mailing Address - Street 2:ROOM 5
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2038
Mailing Address - Country:US
Mailing Address - Phone:808-622-0001
Mailing Address - Fax:808-622-0001
Practice Address - Street 1:960 CENTER STREET
Practice Address - Street 2:ROOM 5
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2038
Practice Address - Country:US
Practice Address - Phone:808-622-0001
Practice Address - Fax:808-622-0001
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT1437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist