Individual
DR. KURT S. BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2356 NW PROFESSIONAL DR, CORVALLIS, OR 97330-3881
(541) 754-0144
(541) 754-0145
Mailing address
2356 NW PROFESSIONAL DR, CORVALLIS, OR 97330-3881
(541) 754-0144
(541) 754-0145
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6925
OR
Other
Enumeration date
09/15/2005
Last updated
08/06/2007
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