Individual
DR. STEVEN W. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14795 SW MURRAY SCHOLLS DR, STE 119, BEAVERTON, OR 97007-9713
(503) 524-0524
Mailing address
PO BOX 1891, LAKE OSWEGO, OR 97035-0612
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D6736
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D6736
OREGON DENTAL LICENSE
OR
Enumeration date
08/02/2006
Last updated
08/02/2010
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