Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. LARRY MILTON BLACK JR., DMD
Active Sole ProprietorDR. LARRY MILTON BLACK JR., DMD is a General Dentistry healthcare provider located in QUITMAN, Georgia. NPI 1164558359 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · QUITMAN, GA
Registration Details
- NPI Number
- 1164558359
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 24, 2007 (19.447234166254 yrs)
- Last Updated
- Aug 14, 2012
- License
-
DN012932 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1306 E SCREVEN STQUITMAN, GA, 316432318Browse GA providers · Browse ZIP 31643
- Phone
- 2292638700
- Fax
- 2292634212
- Primary Specialty
-
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.