| Stacy Black, Dds, Pa | |
|
132 Hatchett Rusk TX 75785 | |
| (903) 683-5751 | |
| Not Available |
| Full Name | Stacy Black, Dds, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 132 Hatchett, Rusk, Texas |
| Authorized Official Name and Position | Stacy Lee Black (MEMBER/PRESIDENT) |
| Authorized Official Contact | 9036835751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy Black, Dds, Pa Po Box 316 Rusk TX 75785-0316 Ph: (903) 683-5751 | Stacy Black, Dds, Pa 132 Hatchett Rusk TX 75785 Ph: (903) 683-5751 |
| NPI Number | 1831584598 |
|---|---|
| Provider Enumeration Date | 03/31/2015 |
| Last Update Date | 03/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831584598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17132 (Texas) | Primary |
Rusk Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 516 N Dickinson Dr Ste B, Rusk, TX 75785 Phone: 903-638-3200 |