MARK JAMES BLACK

CHAMPAIGN, IL
NPI1306286034
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: IL  019-023555)
Enumeration Date2013-06-26
Last Update Date2013-06-26
Business Address
Dr. MARK JAMES BLACK DDS
1717 BROADMOOR DR
CHAMPAIGN, IL 61821-5933
Phone number: 217-359-1541
Mailing Address
Dr. MARK JAMES BLACK DDS
1717 BROADMOOR DR
CHAMPAIGN, IL 61821-5933
Phone number: 217-359-1541
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