| Edward E Black Dds,ms,inc | |
|
3015 Crenshaw Blvd Suite C Los Angeles CA 90016-4264 | |
| (323) 734-1534 | |
| (323) 734-4693 |
| Full Name | Edward E Black Dds,ms,inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3015 Crenshaw Blvd, Los Angeles, California |
| Authorized Official Name and Position | Maria Orellana (OFFICE MANAGER) |
| Authorized Official Contact | 3237341534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward E Black Dds,ms,inc 3015 Crenshaw Blvd Suite C Los Angeles CA 90016-4264 Ph: (323) 734-1534 | Edward E Black Dds,ms,inc 3015 Crenshaw Blvd Suite C Los Angeles CA 90016-4264 Ph: (323) 734-1534 |
| NPI Number | 1508010497 |
|---|---|
| Provider Enumeration Date | 11/05/2008 |
| Last Update Date | 11/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508010497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 17879 (California) | Primary |
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