Individual
DR. JOHN C BLACK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2600 WILLOW STREET PIKE S, WILLOW STREET, PA 17584-9377
(717) 464-3223
(717) 464-4150
Mailing address
2600 WILLOW STREET PIKE S, WILLOW STREET, PA 17584-9377
(717) 464-3223
(717) 464-4150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS026798L
PA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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