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General NPI Number Information
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NPI Number | 1659954428
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Entity Type | Individual
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Provider Name | CLAYTON JAMES MCELROY
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Gender | Male
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Dates
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Enumeration Date | 04/29/2021
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 808-944-1603
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Fax |
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Provider Business Mailing Address
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Address Line | 45-616 PILIPAA ST
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City | KANEOHE
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State | HI
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Zip | 96744-1882
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Country | US
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Telephone | 618-402-0991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DT-3121-0
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License Number State | HI
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