Organization
EDWARD E BLACK DDS,MS,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ORELLANA (OFFICE MANAGER)
(323) 734-1534
Entity
Organization
Contact information
Practice address
3015 CRENSHAW BLVD, SUITE C, LOS ANGELES, CA 90016-4264
(323) 734-1534
(323) 734-4693
Mailing address
3015 CRENSHAW BLVD, SUITE C, LOS ANGELES, CA 90016-4264
(323) 734-1534
(323) 734-4693
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17879
CA
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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