| Divine Dental Works | |
|
427 Stone Wood Dr Broken Arrow OK 74012-1026 | |
| (918) 630-4155 | |
| Not Available |
| Full Name | Divine Dental Works |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 427 Stone Wood Dr, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Trischa Ann Clarke (OWNER) |
| Authorized Official Contact | 9186304155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Dental Works 427 Stone Wood Dr Broken Arrow OK 74012-1026 Ph: (918) 630-4155 | Divine Dental Works 427 Stone Wood Dr Broken Arrow OK 74012-1026 Ph: (918) 630-4155 |
| NPI Number | 1710117999 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 07/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710117999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5859 (Oklahoma) | Primary |
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