Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 1960 | HI |
NPI | 1053464677 |
---|---|
Provider Name | Dr. Brent Ching |
First Address | Honolulu, HI 96826-1081 |
Second Address | Honolulu, HI 96826-1081 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |