Basic Information
| Provider Information | |||||||||
| NPI: | 1982086385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DENTON | ||||||||
| FirstName: | HEIDI | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2180 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WAILUKU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967931625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082426464 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 PRISON ST | ||||||||
| Address2: | |||||||||
| City: | LAHAINA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967611299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086610051 | ||||||||
| FaxNumber: | 8086615975 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2015 | ||||||||
| LastUpdateDate: | 09/11/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A14116 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | DOS-2011 | HI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.