Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 00962 | PR |
NPI | 1144219411 |
---|---|
Provider Name | Dr. Guillermo Enrique Orraca II |
First Address | Honolulu, HI 96818-4914 |
Second Address | Hickam Afb, HI 96853-5399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 13/11/2007 |