DR. STACY BLACKMON, DDS
Dentist
Active
Individual
NPI: 1043334766
Practice Address
1100 VILLAGE HARBOR DRLAKE WYLIE FAMILY DENTISTRY PA
Lake Wylie, SC 29710
Phone: (803) 831-8856
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist | 122300000X | Yes | 3673 (SC) |
Frequently Asked Questions
NPI 1043334766 is the National Provider Identifier for DR. STACY BLACKMON, DDS, a Dentist provider located in Lake Wylie, SC. This NPI was enumerated on March 19, 2007.
DR. STACY BLACKMON, DDS practices at 1100 VILLAGE HARBOR DR, LAKE WYLIE FAMILY DENTISTRY PA, Lake Wylie, SC 29710.
Quick Facts
- NPI
- 1043334766
- Type
- Individual
- Enumerated
- Mar 19, 2007
- Last Updated
- Jul 8, 2007
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