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Mr. Stacy Lee Black, DDSPA
General Practice Dentistry in Rusk, Texas
NPI 1063423085

Stacy Lee Black is a General Practice Dentistry based in Rusk, TX and is specialized in General Practice. Stacy Lee Black practices in Rusk, TX and has the professional credentials of DDSPA. The NPI Number for Stacy Lee Black is 1063423085 and holds a License No. 17132 (Texas).

The current practice location address for Stacy Lee Black is 132 Hatchett St., Rusk, TX and can be reached out via phone at 903-683-5751 and via fax at 903-683-3455.

Location: 132 Hatchett St., Rusk, TX, 75785-0316
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063423085
Provider Name
Stacy Lee Black
Credential
DDSPA
Provider Entity Type
Individual
Gender
Male
Address
132 Hatchett St., Rusk, TX, 75785-0316
Phone Number
903-683-5751
Fax Number
903-683-3455
Provider Enumeration Date
08/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
009120901 05 TX
36871 01 TX DENT
institution
Provider Business Practice Location Address Details
Address
132 Hatchett St.
City
Rusk
State
Texas
Zip
75785
Phone Number
903-683-5751
Fax Number
903-683-3455
person
Provider Business Mailing Address Details
Address
132 Hatchett St.
City
Rusk
State
Texas
Zip
75785
Phone Number
903-683-5751
Fax Number
903-683-3455
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
17132 (Texas)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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