Jerry B. Black, Dds, Pc

LBN: Jerry B. Black, Dds, Pc
Jerry B. Black, Dds, Pc is an health care organization with primary practice located at 1925 E 5600 S , Salt Lake City UT 84121-1351. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Jerry B. Black, Dds, Pc can be contacted via phone (801) 278-0458, or through Black, Jerry Beck via phone (801) 278-0458.

Contact Information

Primary practice address
1925 E 5600 S Salt Lake City UT 84121-1351
Phone: (801) 278-0458
Fax: (801) 278-0460
Website:
Map and Directions
Authorized official contact:
Name: Black, Jerry Beck Doctor of Dental Surgery (DDS)
Phone: (801) 278-0458

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 137953 Utah

Profile Details

NPI number 1487696704
LBN Legal business name Jerry B. Black, Dds, Pc
DBA Doing business as
Authorized official Black, Jerry Beck Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487696704 NPPES
Utah Other 4671 PEHP

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