Organization
HENDERSONVILLE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAIRE L BLACK DDS (PARTNER)
(828) 692-3933
Entity
Organization
Contact information
Practice address
687 BLYTHE STREET CT STE A, HENDERSONVILLE, NC 28739-4054
(828) 692-3933
(828) 692-9946
Mailing address
687 BLYTHE STREET CT STE A, HENDERSONVILLE, NC 28739-4054
(828) 692-3933
(828) 692-9946
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9285
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000755006
UNITED CONCORDIA
—
05
—
7997556
—
NC
01
—
97556
BLUE CROSS BLUE SHIELD OF NC
NC
Enumeration date
09/30/2013
Last updated
09/30/2013
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