Black, Eric

Black, Eric is an individual health care provider with primary practice located at 1260 S Campbell Ave , Green Valley AZ 85614-0504. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Dental Public Health. Dental Providers / Dental Public Health is his primary health care specialty. Black, Eric can be contacted via phone (520) 407-5617.

Contact Information

Primary practice address
1260 S Campbell Ave Green Valley AZ 85614-0504
Phone: (520) 407-5617
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DD2687 New Mexico
Dental Providers / Dental Public Health 1223D0001X 6899 Arizona

Profile Details

NPI number 1154364305
LBN Legal business name Black, Eric
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 2nd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154364305 NPPES
Arizona MEDICAID 974156

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