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1124062872
JERRY BECK BLACK
SALT LAKE CITY, UT
NPI
1124062872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: UT 137953)
Enumeration Date
2006-06-15
Last Update Date
2007-07-08
Business Address
Dr. JERRY BECK BLACK D.D.S.
1925 E 5600 S
SALT LAKE CITY, UT 84121-1351
Phone number: 801-278-0458
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Mailing Address
Dr. JERRY BECK BLACK D.D.S.
8913 RED WILLOW CIR
SANDY, UT 84093-1488
Phone number: 801-255-6742
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