Dr. CHARLES RANDALL BLACK -- DMD
Individual Provider (NPI-1)
Active
Dentist, General Practice
Provider Information
- NPI Number
1205094240- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DMD
- Status
- Active
Contact & Location
- Address
- 26 LONG POND ROAD PLYMOUTH COUNTY CORRECTIONAL FACILITY, PLYMOUTH, MA, 023602606
- Phone
- (508) 830-6200
- Fax
- (508) 830-6358
Specialties & Taxonomies
Dentist, General Practice
Primary License: MA #12990
All Addresses
LOCATION
26 LONG POND ROAD PLYMOUTH COUNTY CORRECTIONAL FACILITY
PLYMOUTH, MA, 023602606