BRIAN JERRY BLACK

SALT LAKE CITY, UT
NPI1457589483
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: UT  7386388-9922)
Enumeration Date2009-06-29
Last Update Date2009-06-29
Business Address
BRIAN JERRY BLACK D.D.S.
1925 E 5600 S
SALT LAKE CITY, UT 84121-1351
Phone number: 801-278-0458
Mailing Address
BRIAN JERRY BLACK D.D.S.
1925 E 5600 S
SALT LAKE CITY, UT 84121-1351
Phone number: 801-278-0458
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