# BYRON H. BLACK, DDS, PLLC

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

## Provider details

- **NPI number:** 1841693355
- **Authorized official:** MRS. RENEE L. JOHNSON RN-BSN (CLINICAL PRACTICE MANAGER)
- **Authorized official phone:** (304) 514-5500

## Contact information

- **Practice address:** 102 MEMORIAL DR, RIPLEY, WV 25271-1164
- **Practice address phone:** (304) 514-5500
- **Practice address fax:** (304) 514-5504
- **Mailing address:** 102 MEMORIAL DRIVE, RIPLEY, WV 25271-0717
- **Mailing address phone:** (304) 514-5500
- **Mailing address fax:** (304) 514-5504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2081 | WV | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 09/29/2014
- **Last updated:** 08/05/2022