Jacquese Black, DDS

NPI 1649387382 · on the registry since 2006

Practice

Address: 900 Summit Ave
Greensboro, NC 27405
Phone: (336) 370-1112
Fax: (336) 544-0739
Organisation at this address: Ballance & Derose Dds Pa
Rafael Rivera, Jr., Dds, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: NC
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina