Individual provider · Type 1 NPI

Charles Clark

Pediatric Dentistry · East Boston, MA

NPI number 1346133287 Active

Practice location

20 Maverick Sq
East Boston, MA 02128-2335

Call (617) 568-4464 Map

Mailing address

1282 Boylston St Unit 1023
Boston, MA 02215-4462

Specialties and licenses

TaxonomyCodeLicense
Pediatric Dentistry Primary 1223P0221X1857730 (MA)

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

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About NPI 1346133287

Charles Clark's National Provider Identifier is 1346133287, issued on May 30, 2025. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in East Boston, MA. The record was last updated on May 30, 2025.