Provider Demographics
NPI:1265419758
Name:PEDODONTIC ASSOCIATES INC
Entity type:Organization
Organization Name:PEDODONTIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST HIPAA PRIVACY SECURITY OFFI
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SATO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-877-0066
Mailing Address - Street 1:98-1005 MOANALUA ROAD
Mailing Address - Street 2:STE 847
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4726
Mailing Address - Country:US
Mailing Address - Phone:808-487-7933
Mailing Address - Fax:808-484-2351
Practice Address - Street 1:31 KAMEHAMEHA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2263
Practice Address - Country:US
Practice Address - Phone:808-877-0066
Practice Address - Fax:808-873-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty