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Stacy Lee Black (DDS PA)

Mr. Stacy Lee Black (DDS PA) is a health care provider specializes in Dentist.

profile-icon Basic Information

Practice Location 132 Hatchett St., Rusk, TX 75785, US
Practice Location Phone903-683-5751
Practice Location Fax903-683-3455
GenderMale
Specialty InDentist
NPI ?1063423085
Entity TypeIndividual
Enumeration Date ? Aug 11, 2006
Last Update Date ? Apr 9, 2015
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Stacy Lee Black

SpecialtySpecializationLicenseLicense State
DentistGeneral Practice 17132Texas

legacy-id-icon Legacy Provider IDs of Stacy Lee Black

Provider IdIssuer StateIssuer TypeIssuer
36871TexasOtherDENT
009120901TexasMedicaid