Organization
SAMUEL BLACK, DMD, PHD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ARTHUR BLACK JR. M.S., D.M.D., PH.D. (PRESIDENT)
(617) 875-3293
Entity
Organization
Contact information
Practice address
3700 OLD FOREST RD., LYNCHBURG, VA 24501
(434) 515-0370
(434) 338-6552
Mailing address
3700 OLD FOREST RD., LYNCHBURG, VA 24501
(434) 515-0370
(434) 338-6552
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401412426
VA
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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