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Individual

DR. DAMIAN LEON BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S., FACP

Contact information

Practice address
16850 S US HIGHWAY 441 STE 301, SUMMERFIELD, FL 34491-8657
(352) 307-3006
Mailing address
16850 S US HIGHWAY 441 STE 301, SUMMERFIELD, FL 34491-8657
(352) 307-3006

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
59429
CA
1223P0700X
Prosthodontics
Primary
DN25591
FL

Other

Enumeration date
08/12/2010
Last updated
08/09/2021
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