| NPI | 1659445997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C BLACK Owner Practi CIO Ner 915-592-5853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 11053) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2009-03-26 |