# NORTH PLATTE VALLEY ORAL & MAXILLOFACIAL SURGERY, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386669133
- **Authorized official:** DR. DENNIS WILLIAM BLACK D.D.S. (PRESIDENT)
- **Authorized official phone:** (308) 633-1760

## Contact information

- **Practice address:** 416 VALLEY VIEW DR, SUITE 800, SCOTTSBLUFF, NE 69361-1486
- **Practice address phone:** (308) 633-1760
- **Practice address fax:** (308) 633-1762
- **Mailing address:** 416 VALLEY VIEW DR, SUITE 800, SCOTTSBLUFF, NE 69361-1486
- **Mailing address phone:** (308) 633-1760
- **Mailing address fax:** (308) 633-1762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5558 | NE | Yes |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 08/22/2020