National Provider Identifier Database

RICHARD F BLACK DMD MPH PC
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

RICHARD F. BLACK, DMD., MPH, PC
15 MEADE ST
SUITE U5
WELLSBORO, PA16901-1813
Phone: 570-724-2141
Fax: 570-724-3942
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for RICHARD F. BLACK, DMD., MPH, PC

NPI Number 1295097699
Legal business name
LBN
RICHARD F. BLACK, DMD., MPH, PC
Authorized official RICHARD BLACK - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/12/2012
Last updated 06/12/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: DS025700L
  • PA Medicaid: 0010875620001
  • PA Other: 141040 PA BLUE SHIELD
  • PA Other: 141040 UNITED CONCORDIA

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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