Mrs. Celia Keisling Clark
Dental Hygienist
55 Camino San Juan
Ridgway
, Colorado 81432-9637
Mrs. Celia Keisling Clark
Dental Hygienist
55 Camino San Juan
Ridgway
, Colorado 81432-9637
(970) 626-4396
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About
Features
Specialties
- Dental Hygienist
Languages spoken
- English
Location
First Address
- Mrs. Celia Keisling Clark
- 55 Camino San Juan
- Ridgway, CO
- Zip : 81432-9637
- Phone : (970) 626-4396
Second Address
- Mrs. Celia Keisling Clark
- 55 Camino San Juan
- Ridgway, CO
- Zip : 81432-9637
- Phone : (970) 626-4396
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 2506 | CO |
National Provider Identifier
| NPI | 1053594796 |
|---|---|
| Provider Name | Mrs. Celia Keisling Clark |
| First Address | Ridgway, CO 81432-9637 |
| Second Address | Ridgway, CO 81432-9637 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/12/2007 |
| Last Update Date | 29/01/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.