Individual
KRISTIN LEE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, OMT
Contact information
Practice address
9001 N MAIN ST FL 2, DAYTON, OH 45415-1175
(937) 836-7282
(937) 836-7394
Mailing address
5520 UNION SHELBY RD, PIQUA, OH 45356-9223
(937) 546-8594
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
31.007966
OH
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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