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Individual
CHRISTIAN BLACK
Active
Individual
CHRISTIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DGD.10222
SC
1223E0200X
Endodontics
Primary
10938
SC
Other
Enumeration date
06/14/2022
Last updated
09/03/2024
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