Individual
DR. TYLER BOYD BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
835 N 700 E STE 2, PROVO, UT 84606-6994
(801) 373-7700
Mailing address
835 N 700 E STE 2, PROVO, UT 84606-6994
(801) 373-7700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14009150-9926
UT
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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