Black, Ty Brandon
Black, Ty Brandon is an sole proprietor health care provider with primary practice located at 5201 S Broadway Ave St 240, Tyler TX 75703-3748. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Black, Ty Brandon can be contacted via phone (903) 534-8110.Contact Information
Primary practice address
5201 S Broadway Ave St 240
Tyler TX 75703-3748
Phone: (903) 534-8110
Fax: (903) 534-5510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 20648 | Texas |
Profile Details
| NPI number | 1851448385 |
|---|---|
| LBN Legal business name | Black, Ty Brandon |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2007 |
| 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.
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