| Richard C Black Dds Ms Pc | |
|
1514 Zaragosa Ste A-2 El Paso TX 79936-7905 | |
| (915) 592-5853 | |
| (915) 591-0381 |
| Full Name | Richard C Black Dds Ms Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1514 Zaragosa, El Paso, Texas |
| Authorized Official Name and Position | Richard C Black (OWNER PRACTICIONER) |
| Authorized Official Contact | 9155925853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard C Black Dds Ms Pc 1514 Zaragosa Ste A-2 El Paso TX 79936-7905 Ph: (915) 592-5853 | Richard C Black Dds Ms Pc 1514 Zaragosa Ste A-2 El Paso TX 79936-7905 Ph: (915) 592-5853 |
| NPI Number | 1659445997 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 03/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659445997 | NPI | - | NPPES |
| 9177596 | Medicaid | NM | |
| 169606401 | Medicaid | TX | |
| 009005202 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 11053 (Texas) | Primary |
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