Provider Demographics
NPI:1558684514
Name:DENNIS M. SAGAWA D.D.S., INC.
Entity type:Organization
Organization Name:DENNIS M. SAGAWA D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:MASAKAZU
Authorized Official - Last Name:SAGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-961-3401
Mailing Address - Street 1:91 LANIHULI ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-7202
Mailing Address - Country:US
Mailing Address - Phone:808-961-3401
Mailing Address - Fax:808-961-6885
Practice Address - Street 1:91 LANIHULI ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7202
Practice Address - Country:US
Practice Address - Phone:808-961-3401
Practice Address - Fax:808-961-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1114261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental