Individual
CHRISTIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4610 OLEANDER DR STE 201, MYRTLE BEACH, SC 29577-5752
(843) 492-6724
Mailing address
4610 OLEANDER DR STE 201, MYRTLE BEACH, SC 29577-5752
(843) 492-6724
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DGD.10222
SC
1223E0200X
Endodontics
Primary
10938
SC
Other
Enumeration date
06/14/2022
Last updated
09/03/2024
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