National Provider Identifier Database

STACY L BLACK, DDS PA – NPI #1063423085
General Practice

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.


Contact Information

STACY L BLACK, DDS PA
132 HATCHETT ST.
RUSK, TX75785
Phone: 903-683-5751
Fax: 903-683-3455
Website:
Specialty Taxonomy Code
* General Practice 1223G0001X

* Indicates primary specialty

NPI Profile & details for STACY L BLACK

NPI Number 1063423085
Credentials DDS PA
Entity Individual
Enumeration date 08/11/2006
Last updated 05/28/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • TX License #: 17132
  • TX Medicaid: 009120901
  • TX Other: 36871 DENT
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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