Provider Demographics
NPI:1891767927
Name:HOLGUIN, RICK (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:HOLGUIN
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:RICHARD
Other - Last Name:HOLGUIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:95-221 KIPAPA DR
Mailing Address - Street 2:STE 4B
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1147
Mailing Address - Country:US
Mailing Address - Phone:808-623-2888
Mailing Address - Fax:808-623-2440
Practice Address - Street 1:75-5706 HANAMA PL
Practice Address - Street 2:SUITE 210
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1745
Practice Address - Country:US
Practice Address - Phone:808-329-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics