Organization
ROBERT S CLARK DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT STEVEN CLARK DDS (OWNER DENTIST)
(781) 826-7577
Entity
Organization
Contact information
Practice address
31 SCHOOSETT STREET, SUITE 101, PEMBROKE, MA 02359
(781) 826-7577
(781) 826-8970
Mailing address
31 SCHOOSETT STREET, SUITE 101, PEMBROKE, MA 02359
(781) 826-7577
(781) 826-8970
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13190
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0248126
—
MA
Enumeration date
11/15/2007
Last updated
11/15/2007
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