| Ancheta Pediatric Dental Llc | |
|
98-1247 Kaahumanu St Suite 205 Aiea HI 96701-5311 | |
| (808) 487-1009 | |
| (808) 487-1004 |
| Full Name | Ancheta Pediatric Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 98-1247 Kaahumanu St, Aiea, Hawaii |
| Authorized Official Name and Position | Janel Ancheta-carroll (OWNER/PEDIATRIC DENTIST) |
| Authorized Official Contact | 8085612054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ancheta Pediatric Dental Llc 98-1247 Kaahumanu St Suite 205 Aiea HI 96701-5311 Ph: (808) 487-1009 | Ancheta Pediatric Dental Llc 98-1247 Kaahumanu St Suite 205 Aiea HI 96701-5311 Ph: (808) 487-1009 |
| NPI Number | 1891235560 |
|---|---|
| Provider Enumeration Date | 03/01/2017 |
| Last Update Date | 03/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891235560 | NPI | - | NPPES |
| 574857-03 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DT-2079 (Hawaii) | Primary |
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› Verified 9 days ago
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