Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 6774 | NE |
Y | 1223P0221X | Pediatric Dentist | DT2342 | HI |
NPI | 1093963704 |
---|---|
Provider Name | Dr. Renee Chie Uchida |
First Address | Honolulu, HI 96816-5319 |
Second Address | Honolulu, HI 96816-5319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2008 |
Last Update Date | 21/06/2010 |