Individual
CHELSEA R BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
428 N 8TH ST, AUBURN, IL 62615-1006
(217) 741-8136
Mailing address
428 N 8TH ST, AUBURN, IL 62615-1006
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
02015698
IL
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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