Individual
DR. CHARLES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 MAVERICK SQ, EAST BOSTON, MA 02128-2335
(617) 568-4464
Mailing address
1282 BOYLSTON ST UNIT 1023, BOSTON, MA 02215-4462
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1857730
MA
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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