Provider Demographics
NPI:1891020855
Name:OAMIL-PACHO, EDITH C (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:C
Last Name:OAMIL-PACHO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-673 KUPUOHI STREET
Mailing Address - Street 2:C101
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5372
Mailing Address - Country:US
Mailing Address - Phone:808-677-5588
Mailing Address - Fax:808-677-6588
Practice Address - Street 1:94-673 KUPUOHI ST
Practice Address - Street 2:C101
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5367
Practice Address - Country:US
Practice Address - Phone:808-677-5588
Practice Address - Fax:808-677-6588
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT19481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice