Provider Demographics
NPI:1114008869
Name:THOMAS, PAUL W
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:W
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:525 PEAHI RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5419
Mailing Address - Country:US
Mailing Address - Phone:808-575-2815
Mailing Address - Fax:
Practice Address - Street 1:95 MAHALANI ST STE 21
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2521
Practice Address - Country:US
Practice Address - Phone:808-244-7428
Practice Address - Fax:808-242-6676
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICSDT-22122300000X
CA40031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist