Charles Milton Clark, DMD is a medicare enrolled "Dentist" provider in Chesterfield, South Carolina. His current practice location is
918 Holly St, Chesterfield, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(843) 623-2053.
Charles Milton Clark is licensed to practice in South Carolina (license number 1921) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1346381886.
Healthcare Provider's Profile
Full Name | Charles Milton Clark |
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Gender | Male |
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Speciality | Dentist |
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Location | 918 Holly St, Chesterfield, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1346381886
- Provider Enumeration Date: 02/09/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0547566374
- Enrollment ID: I20160304000354
Medical Identifiers
Medical identifiers for Charles Milton Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1346381886 | NPI | - | NPPES |
Z19212 | Medicaid | SC | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 1921 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Milton Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Charles Milton Clark, DMD Po Box 70, Chesterfield, SC 29709 Ph: (843) 623-2053 | Charles Milton Clark, DMD 918 Holly St, Chesterfield, SC 29709 Ph: (843) 623-2053 |
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