Provider Demographics
NPI:1477680296
Name:DAYTON Q.L. LUM, D.D.S., INC.
Entity type:Organization
Organization Name:DAYTON Q.L. LUM, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAYTON
Authorized Official - Middle Name:QL
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-456-5005
Mailing Address - Street 1:850 KAMEHAMEHA HIGHWAY
Mailing Address - Street 2:SUITE 155
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2657
Mailing Address - Country:US
Mailing Address - Phone:808-456-5005
Mailing Address - Fax:808-454-2569
Practice Address - Street 1:850 KAMEHAMEHA HIGHWAY
Practice Address - Street 2:SUITE 155
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2657
Practice Address - Country:US
Practice Address - Phone:808-456-5005
Practice Address - Fax:808-454-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty