Organization
MICHAEL A. CLARKE, D.D.S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A CLARKE D.D.S. (OWNER)
(808) 969-3830
Entity
Organization
Contact information
Practice address
31 E LANIKAULA ST STE B, HILO, HI 96720-4362
(808) 969-3830
(808) 969-1189
Mailing address
31 E LANIKAULA ST STE B, HILO, HI 96720-4362
(808) 969-3830
(808) 969-1189
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DT1403
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT1403
DT-1403
HI
Enumeration date
04/10/2015
Last updated
04/10/2015
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