Individual
MICHAEL ANDREW CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
31 E LANIKAULA ST, SUITE B, HILO, HI 96720-4362
(808) 969-3830
(808) 969-1189
Mailing address
31 E LANIKAULA ST, SUITE B, HILO, HI 96720-4362
(808) 969-3830
(808) 969-1189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1403
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02278001
—
HI
Enumeration date
10/10/2006
Last updated
07/08/2007
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