Healthcare Provider Details

I. General information

NPI: 1629993126
Provider Name (Legal Business Name): CLUTCH DENTAL ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252B MAIN STREET
ACTON MA
01720
US

IV. Provider business mailing address

46 LORING AVE
BOXBOROUGH MA
01719-1533
US

V. Phone/Fax

Practice location:
  • Phone: 978-393-3233
  • Fax: 987-393-3230
Mailing address:
  • Phone: 301-704-8964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CAMESIA ODESSA MATTHEWS
Title or Position: DOCTOR
Credential: DDS
Phone: 301-704-8964