NPI | 1467422022 |
---|---|
Professional Name | STEVEN WAYNE BLACK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ID D-3652-EN) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MS ENDO-526-17) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2021-09-09 |