Organization
BLACKSTONE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN BLACK (OWNER)
(801) 278-0458
Entity
Organization
Contact information
Practice address
6710 S BLACKSTONE RD, SALT LAKE CITY, UT 84121-6072
(801) 278-0458
(801) 278-0460
Mailing address
6710 S BLACKSTONE RD, SALT LAKE CITY, UT 84121-6072
(801) 278-0458
(801) 278-0460
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7386388-9922
UT
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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