Individual
MICHAEL SPOELSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
NAVAL HEALTH CLINIC HAWAII, 480 CENTRAL AVENUE, PEARL HARBOR, HI 96860
(517) 435-9914
Mailing address
NAVAL HEALTH CLINIC HAWAII, 480 CENTRAL AVENUE, PEARL HARBOR, HI 96860
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901021245
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901021245
MI
Other
Enumeration date
12/02/2014
Last updated
09/30/2022
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