Ty Black DDS
Ty Black DDS is a Dentist in Tyler, Texas. Licensed in Texas. Registered with an NPI since 2009.
- Licensed in
- TX
- In the registry since
- 2009
Practice location Address checks out
5201 S Broadway Ave St 240Tyler, TX 75703
Phone: (903) 534-8110
Fax: (903) 534-5510
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence 20648 (TX) |
|---|
Record details
| NPI number | 1437383015 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Dana Black — Off Mgr · (903) 534-8110 |
| NPI enumerated | May 11, 2009 |
| Last updated in NPPES | May 11, 2009 |
| Mailing address | 5201 S Broadway Ave, St 240, Tyler, TX 75703-3748 |
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