Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2504 | HI |
N | 1223D0001X | Dental Public Health | 195 | HI |
NPI | 1386903631 |
---|---|
Provider Name | Heather Lenore Cantori |
First Address | Hilo, HI 96720-2975 |
Second Address | Keaau, HI 96749-8134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2012 |
Last Update Date | 24/03/2013 |