Organization
MARCUS BLACK, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS DEWITT BLACK D.D.S. (DENTIST)
(479) 464-0900
Entity
Organization
Contact information
Practice address
2109 SOUTH 54TH STREET, ROGERS, AR 72758-8195
(479) 464-0900
(479) 464-0708
Mailing address
2109 SOUTH 54TH STREET, ROGERS, AR 72758-8195
(479) 464-0900
(479) 464-0708
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2858
AR
122300000X
Dentist
3664
AR
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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