Stacy L Blackmon is a Dentist in Lake Wylie, South Carolina. Stacy L Blackmon practices all healthcare services and medical treatments related to Dentist. The NPI Number for Stacy L Blackmon is 1043334766. The last update date is 2007-07-08.
Stacy L Blackmon's current location address is 1100 Village Harbor Dr, Lake Wylie, South Carolina. You can contact this provider via phone number 8038318856 and fax number 8038318966. The mailing address for Stacy L Blackmon is 1100 Village Harbor Dr, Lake Wylie, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stacy L Blackmon |
|---|---|
| Address | 1100 Village Harbor Dr, Lake Wylie, South Carolina |
| Phone Number | 8038318856 |
| Fax Number | 8038318966 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1043334766 |
|---|---|
| Provider Enumeration Date | 2007-03-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1100 Village Harbor Dr |
|---|---|
| City | Lake Wylie |
| State | South Carolina (SC) |
| Post Code | 29710 |
| Phone Number | 8038318856 |
| Fax Number | 8038318966 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 3673 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Stacy L Blackmon?
The Stacy L Blackmon has been issued the NPI (National Provider Identifier) 1043334766 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Stacy L Blackmon is physically located?
The Stacy L Blackmon is situated at the following address: 1100 Village Harbor Dr, Lake Wylie, SC 29710.
What is Stacy L Blackmon's area of expertise and its corresponding taxonomy classification?
The Stacy L Blackmon's field of specialization is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services issue the 1043334766 to Stacy L Blackmon?
The Stacy L Blackmon received its 1043334766 assignment from the Centers for Medicare & Medicaid Services on 2007-03-19.
When was the information regarding Stacy L Blackmon, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Stacy L Blackmon, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.