Individual
DR. HARRISON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1267
FL
1223P0221X
Pediatric Dentistry
Primary
61482
KS
1223P0221X
Pediatric Dentistry
DN21749
FL
Other
Enumeration date
08/22/2014
Last updated
02/28/2022
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