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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