RICHARD F. BLACK, DMD., MPH, PC; NPI #1295097699

Contact Information

RICHARD F. BLACK, DMD., MPH, PC

15 MEADE ST
SUITE U5
WELLSBORO, PA 16901-1813

Phone: 570-724-2141
Fax: 570-724-3942
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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

NPI # 1295097699

LBN Legal business name RICHARD F. BLACK, DMD., MPH, PC

Authorized official RICHARD BLACK - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/12/2012

Last updated 06/12/2012 - About 14 years ago

Identifiers

PA	License #	DS025700L
PA	Medicaid	0010875620001
PA	Other	141040	PA BLUE SHIELD
PA	Other	141040	UNITED CONCORDIA

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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