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Organization
MISTY MICHELLE BLACK DDS INC
Active
Organization
MISTY MICHELLE BLACK DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISTY MICHELLE BLACK DDS (OWNER)
(323) 734-1534
Entity
Organization
Contact information
Practice address
3015 CRENSHAW BLVD # C, LOS ANGELES, CA 90016-4264
(323) 734-1534
Mailing address
3015 CRENSHAW BLVD # C, LOS ANGELES, CA 90016-4264
(323) 734-1534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
59622
CA
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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