Black, Joel A
Black, Joel A is an individual health care provider with primary practice located at 3314 Healy Dr Suite 104, Winston Salem NC 27103-1408. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Black, Joel A can be contacted via phone (336) 765-5421.Contact Information
Primary practice address
3314 Healy Dr Suite 104
Winston Salem NC 27103-1408
Phone: (336) 765-5421
Fax: (336) 760-9952
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 3648 | North Carolina |
Profile Details
| NPI number | 1427112978 |
|---|---|
| LBN Legal business name | Black, Joel A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427112978 | NPPES |
| North Carolina | MEDICAID | 8990753 | |
| North Carolina | Other | 1225074172 |
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