Provider Demographics
NPI:1972735066
Name:GARRET G MIYAGAWA DDS INC
Entity Type:Organization
Organization Name:GARRET G MIYAGAWA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRET
Authorized Official - Middle Name:G
Authorized Official - Last Name:MIYAGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-247-2700
Mailing Address - Street 1:46-022 KAM HWY
Mailing Address - Street 2:RM 201
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3714
Mailing Address - Country:US
Mailing Address - Phone:808-247-2700
Mailing Address - Fax:808-247-2700
Practice Address - Street 1:46-022 KAM HWY
Practice Address - Street 2:RM 201
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3714
Practice Address - Country:US
Practice Address - Phone:808-247-2700
Practice Address - Fax:808-247-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1621261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental