Individual
CINDEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
485 YAMPA AVE, CRAIG, CO 81625-2609
(970) 824-8000
(970) 824-1179
Mailing address
485 YAMPA AVE, CRAIG, CO 81625-2609
(970) 824-8000
(970) 824-1179
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2434
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23
—
CO
05
—
24
—
CO
05
—
35
—
CO
05
—
41
—
CO
05
—
E17
—
CO
05
—
E18
—
CO
05
—
E19
—
CO
05
—
E20
—
CO
05
—
E21
—
CO
Enumeration date
07/29/2015
Last updated
07/29/2015
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