Provider Demographics
NPI:1053404285
Name:PARATO, MARLON CLUTARIO (DMD)
Entity type:Individual
Prefix:MR
First Name:MARLON
Middle Name:CLUTARIO
Last Name:PARATO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:#917
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-942-5639
Mailing Address - Fax:808-949-6480
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:#917
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-942-5639
Practice Address - Fax:808-949-6480
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49731403Medicaid