# BLACK MYRTLE ENDODONTICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Black Myrtle Endodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790512655
- **Authorized official:** CHRISTIAN BLACK DMD, MSD (OWNER)
- **Authorized official phone:** (843) 492-6724

## Contact information

- **Practice address:** 4610 OLEANDER DR STE 201, MYRTLE BEACH, SC 29577-5752
- **Practice address phone:** (843) 492-6724
- **Mailing address:** 4610 OLEANDER DR STE 201, MYRTLE BEACH, SC 29577-5752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | Yes |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2024
- **Last updated:** 09/16/2024