DR. Stacy L Blackmon, DDS
NPI #1043334766 in Lake Wylie, South Carolina
Provider Information
- NPI Number
- 1043334766
- Entity Type
- Individual
- Name
- DR. Stacy L Blackmon, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Mar 19, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1100 VILLAGE HARBOR DR
- Address 2
- LAKE WYLIE FAMILY DENTISTRY PA
- City
- Lake Wylie
- State
- South Carolina
- ZIP Code
- 29710
- Phone
- (803) 831-8856
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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|---|---|
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