Black, Jerry Beck
Black, Jerry Beck is an individual health care provider with primary practice located at 1925 E 5600 S , Salt Lake City UT 84121-1351. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Black, Jerry Beck can be contacted via phone (801) 278-0458.Contact Information
Primary practice address
1925 E 5600 S
Salt Lake City UT 84121-1351
Phone: (801) 278-0458
Fax: (801) 278-0460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 137953 | Utah |
Profile Details
| NPI number | 1124062872 |
|---|---|
| LBN Legal business name | Black, Jerry Beck |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124062872 | NPPES |
| Utah | Other | 4671 | PEHP |
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