Stacy Blackmon, DDS

NPI 1043334766 · on the registry since 2007

Practice

Address: 1100 Village Harbor Dr
Lake Wylie Family Dentistry Pa
Lake Wylie, SC 29710
Phone: (803) 831-8856
Fax: (803) 831-8966
Organisation at this address: Lake Wylie Family Dentistry Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 122300000X
122300000X
Licence states on file: SC
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Carolina