Charles Black Iii Dmd Pa

NPI 1063568848 - Dentist - 1223S0112X

NPI Details
NPI 1063568848
Enumeration Date 01/26/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CHARLES CHARLES
Position OWNER
Phone (251) 343-3415
Fax (251) 343-3417
Practice Location
4728 AIRPORT BLVD
SUITE C
MOBILE AL, 36608, US
Phone (251) 343-3415
Fax (251) 343-3417
Business Location
4728 AIRPORT BLVD
SUITE C
MOBILE AL, 36608, US
Phone (251) 343-3415
Fax (251) 343-3417
Toxanomy
Taxonomy Code 1223S0112X
License State Alabama
License Number 3146
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According to our database, Charles Black Iii Dmd Pa NPI is 1063568848, taxonomy code is 1223S0112X and license number is 3146, license state is located at Alabama. Charles Black Iii Dmd Pa physically located at 4728 Airport Blvd, Mobile AL, 36608. NPI Number 1033115704 has the healthcare provider type.

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1063568848 NPI number is provided on an as is basis without warranty of any kind. 1063568848 is maintained by the National Plan & Provider Enumeration System. The contents of Charles Black Iii Dmd Pa are for informational purposes only.