Individual
DR. JAY A BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
315 MCHUGH BLVD, 2D DEN BN/NDC, CAMP LEJEUNE, NC 28547-2511
(910) 451-2208
(910) 451-8036
Mailing address
315 MCHUGH BLVD, 2D DEN BN/NDC, CAMP LEJEUNE, NC 28547-2511
(910) 451-2208
(910) 451-8036
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
0401008403
VA
Other
Enumeration date
02/08/2006
Last updated
08/01/2007
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