Provider Demographics
NPI:1053771659
Name:PAYETTE, EVA (DMD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:PAYETTE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 KILAUEA AVE., SUITE 100
Mailing Address - Street 2:HILO FAMILY DENTAL CENTER
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-333-3456
Mailing Address - Fax:808-930-0438
Practice Address - Street 1:1257 KILAUEA AVE., SUITE 100
Practice Address - Street 2:HILO FAMILY DENTAL CENTER
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-333-3456
Practice Address - Fax:808-930-0438
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program