# TRISCHA A. CLARKE D.D.S., P.L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Divine Dental Works
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710117999
- **Authorized official:** DR. TRISCHA ANN CLARKE D.D.S. (OWNER)
- **Authorized official phone:** (918) 630-4155

## Contact information

- **Practice address:** 427 STONE WOOD DR, BROKEN ARROW, OK 74012-1026
- **Practice address phone:** (918) 630-4155
- **Mailing address:** 427 STONE WOOD DR, BROKEN ARROW, OK 74012-1026
- **Mailing address phone:** (918) 630-4155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 5859 | OK | Yes |

## Other

- **Enumeration date:** 07/22/2009
- **Last updated:** 07/22/2009