Individual
STEPHEN J BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
288 BELMONT STREET, BROCKTON, MA 02301
(508) 583-0103
(508) 583-0140
Mailing address
288 BELMONT STREET, MASSASOIT DENTAL ASSOCIATES, BROCKTON, MA 02301
(508) 583-0103
(508) 583-0140
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13600
MA
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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