Dr Larry Milton Black Jr, DMD is a
Dentist - General Practice based in Quitman, Georgia. Dr Larry Milton Black Jr is licensed to practice in Georgia (license number DN012932) and his current practice location is
1306 E Screven St, Quitman, Georgia. He can be reached at his office (for appointments etc.) via phone at
(229) 263-8700.
NPI number for Dr Larry Milton Black Jr is 1164558359 and his current mailing address is 1306 E Screven St, Quitman, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164558359.
Healthcare Provider's Profile
Full Name | Dr Larry Milton Black Jr |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 1306 E Screven St, Quitman, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164558359
- Provider Enumeration Date: 02/24/2007
- Last Update Date: 08/14/2012
Medical Identifiers
Medical identifiers for Dr Larry Milton Black Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164558359 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | DN012932 (Georgia) | 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. Dr Larry Milton Black Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Larry Milton Black Jr, DMD 1306 E Screven St, Quitman, GA 31643-2318 Ph: (229) 263-8700 | Dr Larry Milton Black Jr, DMD 1306 E Screven St, Quitman, GA 31643-2318 Ph: (229) 263-8700 |
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