Individual
DR. TYSON BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2650 NORTH AVE UNIT 101, GRAND JUNCTION, CO 81501-6403
(970) 255-1222
(970) 254-8097
Mailing address
2650 NORTH AVE UNIT 101, GRAND JUNCTION, CO 81501-6403
(970) 255-1222
(970) 254-8097
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5562073-9921
UT
Other
Enumeration date
06/11/2008
Last updated
02/03/2009
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