| Michael E. Clarke Ddsms | |
|
24 N Church St Suite 206 Wailuku HI 96793-1680 | |
| (808) 242-0077 | |
| (808) 243-8007 |
| Full Name | Michael E. Clarke Ddsms |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 24 N Church St, Wailuku, Hawaii |
| Authorized Official Name and Position | Michael Ellsworth Clarke (OWNER) |
| Authorized Official Contact | 8082420077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E. Clarke Ddsms 24 N Church St Suite 206 Wailuku HI 96793-1680 Ph: (808) 242-0077 | Michael E. Clarke Ddsms 24 N Church St Suite 206 Wailuku HI 96793-1680 Ph: (808) 242-0077 |
| NPI Number | 1073644068 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073644068 | NPI | - | NPPES |
| 526220-01 | Medicaid | HI | |
| 00C0059976 | Other | HI | HAWAII MEDICAL SERVICE AS |
| 1439 | Other | HI | HAWAII DENTAL SERVICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (Hawaii) | Primary |
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