Individual
DR. STEPHEN R. BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1231 CANDELARIA RD NW, ALBUQUERQUE, NM 87107-2767
(505) 843-7581
Mailing address
3637 GRAPE ST, SAN DIEGO, CA 92104-5715
(310) 733-7116
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2942
NM
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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