Individual
CAROLINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5151 PLANK RD STE 28, BATON ROUGE, LA 70805-3501
(225) 330-6622
(225) 356-8163
Mailing address
5151 PLANK RD STE 28, BATON ROUGE, LA 70805-3501
(225) 330-6622
(225) 356-8163
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5957
LA
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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