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Organization

BRAZOS VALLEY DENTAL GROUP, LLC

Active
Other names
Brazos Valley Dental Group, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN S BLACK DDS (DENTIST / OWNER)
(979) 695-8000
Entity
Organization

Contact information

Practice address
219 ROCK PRAIRIE RD STE 100, COLLEGE STATION, TX 77845-8796
(979) 695-8000
(979) 314-9702
Mailing address
219 ROCK PRAIRIE RD STE 100, COLLEGE STATION, TX 77845-8796
(979) 695-8000
(979) 314-9702

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/06/2022
Last updated
12/06/2022
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