Provider Demographics
NPI:1952301509
Name:YAMAGUMA, EUGENE YUKITO (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:YUKITO
Last Name:YAMAGUMA
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
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Mailing Address - Street 1:1885 MAIN ST
Mailing Address - Street 2:STE. 208
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1819
Mailing Address - Country:US
Mailing Address - Phone:808-242-4774
Mailing Address - Fax:808-242-8445
Practice Address - Street 1:1885 MAIN ST
Practice Address - Street 2:STE. 208
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1819
Practice Address - Country:US
Practice Address - Phone:808-242-4774
Practice Address - Fax:808-242-8445
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI010301223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics