Individual
DR. CLARK W GRILLIOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 N 6TH ST, MCALESTER, OK 74501-4737
(918) 423-0200
(918) 423-6940
Mailing address
215 N 6TH ST, MCALESTER, OK 74501-4737
(918) 423-0200
(918) 423-6940
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6390
OK
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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