Provider Demographics
NPI:1861401713
Name:WROBEL, DOUGLAS CAMBRIAN (D,D,S,)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CAMBRIAN
Last Name:WROBEL
Suffix:
Gender:M
Credentials:D,D,S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7192 KALANIANAOLE HWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1800
Mailing Address - Country:US
Mailing Address - Phone:808-396-9619
Mailing Address - Fax:808-395-4475
Practice Address - Street 1:7192 KALANIANAOLE HWY
Practice Address - Street 2:SUITE 215
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1800
Practice Address - Country:US
Practice Address - Phone:808-396-9619
Practice Address - Fax:808-395-4475
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-16031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice