Individual
MICHELLE RAE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
2014 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4229
(970) 625-5200
Mailing address
PO BOX 2138, ASPEN, CO 81612-2138
(352) 871-2870
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH002026398
CO
Other
Enumeration date
06/22/2022
Last updated
08/01/2023
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