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Organization
SAMUEL BLACK, DMD, PHD, PC
Active
Organization
SAMUEL BLACK, DMD, PHD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ARTHUR BLACK JR. M.S., D.M.D., PH.D. (PRESIDENT)
(617) 875-3293
Entity
Organization
Contact information
Practice address
3700 OLD FOREST RD., LYNCHBURG, VA 24501
(434) 515-0370
(434) 338-6552
Mailing address
3700 OLD FOREST RD., LYNCHBURG, VA 24501
(434) 515-0370
(434) 338-6552
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401412426
VA
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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