Individual
PERRIN JEFFERSON BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
3210 SILAS CREEK PARKWAY, SUITE #4, WINSTON-SALEM, NC 27103
(336) 724-1235
(336) 750-0568
Mailing address
3210 SILAS CREEK PARKWAY, UNIT #4 SUITE #4, WINSTON-SALEM, NC 27103
(336) 724-1235
(336) 750-0568
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6939
NC
Other
Enumeration date
07/01/2008
Last updated
11/04/2008
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