Provider Demographics
NPI:1992782262
Name:MCMULLAN-VOGEL, CANDICE G (DDS, FAGD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:G
Last Name:MCMULLAN-VOGEL
Suffix:
Gender:F
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 LAUKAHI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1432
Mailing Address - Country:US
Mailing Address - Phone:808-373-4321
Mailing Address - Fax:808-373-5198
Practice Address - Street 1:1594 LAUKAHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1432
Practice Address - Country:US
Practice Address - Phone:808-373-4321
Practice Address - Fax:808-373-5198
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT20151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice