Provider Demographics
NPI:1194953083
Name:GEORGE A. KANNA DDS, INC
Entity type:Organization
Organization Name:GEORGE A. KANNA DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANWOOD
Authorized Official - Middle Name:H
Authorized Official - Last Name:KANNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-335-5554
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:3490 HANAPEPE RD
Mailing Address - City:HANAPEPE
Mailing Address - State:HI
Mailing Address - Zip Code:96716-0527
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3490 HANAPEPE RD.
Practice Address - Street 2:
Practice Address - City:HANAPEPE
Practice Address - State:HI
Practice Address - Zip Code:96716-0527
Practice Address - Country:US
Practice Address - Phone:808-335-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty