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Individual

MR. DANNY EARL BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1600 S COULTER ST, BLDG G, SUITE 500, AMARILLO, TX 79106-1710
(806) 351-2762
(806) 351-2763
Mailing address
9105 GASTON AVE, AMARILLO, TX 79119-6340
(806) 355-3694

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20035
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
147448802
TX
01
G601311
CHIPS
TX
Enumeration date
09/06/2006
Last updated
05/21/2015
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