Individual
DR. HARRISON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3305 E DOUGLAS AVE STE 101, WICHITA, KS 67218-1037
(316) 223-4455
(316) 223-4455
Mailing address
3305 E DOUGLAS AVE STE 101, WICHITA, KS 67218-1037
(163) 223-4455
(316) 223-4455
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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