Organization
BYRON H. BLACK, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE L. JOHNSON RN-BSN (CLINICAL PRACTICE MANAGER)
(304) 514-5500
Entity
Organization
Contact information
Practice address
102 MEMORIAL DR, RIPLEY, WV 25271-1164
(304) 514-5500
(304) 514-5504
Mailing address
102 MEMORIAL DRIVE, RIPLEY, WV 25271-0717
(304) 514-5500
(304) 514-5504
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2081
WV
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/29/2014
Last updated
08/05/2022
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