Individual
DR. ELENA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, PHD
Contact information
Practice address
30 COURTHOUSE RD, RICHMOND, VA 23236-3124
(617) 875-3106
Mailing address
12031 DUNNOTTAR DR, CHESTERFIELD, VA 23838-5322
(617) 875-3106
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401412779
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
10225
MA
Other
Enumeration date
08/19/2008
Last updated
01/20/2011
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