NPI 1063568848

Charles Black III DMD PA

Organisation Oral and Maxillofacial Surgery (Dentist) Mobile, AL

Practice location

Address: 4728 Airport Blvd Suite C, Mobile, AL 36608
Phone: (251) 343-3415
Fax: (251) 343-3417

Authorised official

Name: Charles Black
Title: Owner
Phone: (251) 343-3415

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence 3146 (AL)

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Registry record

NPI: 1063568848
Entity type: Organization
NPI issued: 26 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.