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General NPI Number Information
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NPI Number | 1457113581
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Entity Type | Individual
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Provider Name | MARGEAUX BLACK DDS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 14697 DELAWARE ST UNIT 210
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City | WESTMINSTER
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State | CO
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Zip | 80023-9262
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Country | US
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Telephone | 303-650-0310
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Fax |
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Provider Business Mailing Address
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Address Line | 14351 E TENNESSEE AVE UNIT 306
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City | AURORA
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State | CO
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Zip | 80012-3917
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Country | US
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Telephone | 406-491-3879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DEN.00205526
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License Number State | CO
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