| Stephen G. Blank, Dds, Pa | |
|
184 Nw Central Park Plz Port St Lucie FL 34986-2451 | |
| (772) 878-7348 | |
| Not Available |
| Full Name | Stephen G. Blank, Dds, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 184 Nw Central Park Plz, Port St Lucie, Florida |
| Authorized Official Name and Position | Stephen G Blank (PRESIDENT) |
| Authorized Official Contact | 7728787348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen G. Blank, Dds, Pa 184 Nw Central Park Plz Port St Lucie FL 34986-2451 Ph: (772) 878-7348 | Stephen G. Blank, Dds, Pa 184 Nw Central Park Plz Port St Lucie FL 34986-2451 Ph: (772) 878-7348 |
| NPI Number | 1699256792 |
|---|---|
| Provider Enumeration Date | 08/27/2018 |
| Last Update Date | 08/27/2018 |
| Medicare PECOS PAC ID | 6204170335 |
|---|---|
| Medicare Enrollment ID | O20181130000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699256792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN9155 (Florida) | Primary |
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