Organization
RICHARD C BLACK DDS MS PC
Active
Other names
El Paso Orthodontic Assoc PC
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD C BLACK DDS MS (OWNER PRACTICIONER)
(915) 592-5853
Entity
Organization
Contact information
Practice address
1514 ZARAGOSA, STE A-2, EL PASO, TX 79936-7905
(915) 592-5853
(915) 591-0381
Mailing address
1514 ZARAGOSA, STE A-2, EL PASO, TX 79936-7905
(915) 592-5853
(915) 591-0381
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009005202
—
TX
05
—
169606401
—
TX
05
—
9177596
—
NM
Enumeration date
11/20/2006
Last updated
03/26/2009
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