Organization
CLARK L. SCRIVEN, DDS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH FREEBURAG (OFFICE MANAGER)
(970) 522-8518
Entity
Organization
Contact information
Practice address
629 HOLLY DR, STERLING, CO 80751-4539
(970) 522-8518
Mailing address
629 HOLLY DR, STERLING, CO 80751-4539
(970) 522-8518
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
727
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02007276
—
CO
05
—
04019360
—
CO
Enumeration date
06/11/2008
Last updated
06/12/2008
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