Individual
DR. ALAN HOWARD BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
240 PATCHOGUE YAPHANK RD, SUITE 104, EAST PATCHOGUE, NY 11772-4868
(631) 289-3331
Mailing address
11 ORANGE ST, DEER PARK, NY 11729-3524
(631) 667-3835
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
035629-1
NY
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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