Provider Demographics
NPI:1487976122
Name:ROYCE Y FUJIMOTO DDS INC
Entity type:Organization
Organization Name:ROYCE Y FUJIMOTO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYCE
Authorized Official - Middle Name:YOSHIO
Authorized Official - Last Name:FUJIMOTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-245-2852
Mailing Address - Street 1:3136 AKAHI ST STE C
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1100
Mailing Address - Country:US
Mailing Address - Phone:808-245-2852
Mailing Address - Fax:808-245-4558
Practice Address - Street 1:3136 AKAHI ST STE C
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1100
Practice Address - Country:US
Practice Address - Phone:808-245-2852
Practice Address - Fax:808-245-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty