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Organization
TRISCHA A. CLARKE D.D.S., P.L.L.C.
Active
Organization
TRISCHA A. CLARKE D.D.S., P.L.L.C.
Active
Other names
Divine Dental Works
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRISCHA ANN CLARKE D.D.S. (OWNER)
(918) 630-4155
Entity
Organization
Contact information
Practice address
427 STONE WOOD DR, BROKEN ARROW, OK 74012-1026
(918) 630-4155
Mailing address
427 STONE WOOD DR, BROKEN ARROW, OK 74012-1026
(918) 630-4155
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5859
OK
Other
Enumeration date
07/22/2009
Last updated
07/22/2009
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