| Charles Black Iii Dmd Pa | |
|
4728 Airport Blvd Suite C Mobile AL 36608 | |
| (251) 343-3415 | |
| (251) 343-3417 |
| Full Name | Charles Black Iii Dmd Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4728 Airport Blvd, Mobile, Alabama |
| Authorized Official Name and Position | Charles Black (OWNER) |
| Authorized Official Contact | 2513433415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Black Iii Dmd Pa 4728 Airport Blvd Suite C Mobile AL 36608 Ph: (251) 343-3415 | Charles Black Iii Dmd Pa 4728 Airport Blvd Suite C Mobile AL 36608 Ph: (251) 343-3415 |
| NPI Number | 1063568848 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063568848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 3146 (Alabama) | Primary |
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