Organization
NORTH PLATTE VALLEY ORAL & MAXILLOFACIAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS WILLIAM BLACK D.D.S. (PRESIDENT)
(308) 633-1760
Entity
Organization
Contact information
Practice address
416 VALLEY VIEW DR, SUITE 800, SCOTTSBLUFF, NE 69361-1486
(308) 633-1760
(308) 633-1762
Mailing address
416 VALLEY VIEW DR, SUITE 800, SCOTTSBLUFF, NE 69361-1486
(308) 633-1760
(308) 633-1762
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5558
NE
Other
Enumeration date
07/13/2006
Last updated
08/22/2020
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