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General NPI Number Information
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NPI Number | 1629993126
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Entity Type | Organization
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Legal Business Name | CLUTCH DENTAL ENTERPRISES LLC
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 252B MAIN STREET
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City | ACTON
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State | MA
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Zip | 01720
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Country | US
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Telephone | 978-393-3233
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Fax | 987-393-3230
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Provider Business Mailing Address
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Address Line | 46 LORING AVE
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City | BOXBOROUGH
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State | MA
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Zip | 01719-1533
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Country | US
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Telephone | 301-704-8964
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CAMESIA ODESSA MATTHEWS
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Credential | DDS
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Telephone | 301-704-8964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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