Individual
DR. ELIZABETH ANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
18100 MACK AVE, GROSSE POINTE, MI 48230-6252
(313) 884-6680
Mailing address
18100 MACK AVE, GROSSE POINTE, MI 48230-6252
(313) 884-6680
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
050869
NY
122300000X
Dentist
Primary
2901600749
MI
Other
Enumeration date
04/08/2007
Last updated
09/19/2023
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