NPI 1003016791

Stephen Gary Blank, DDS

Practitioner General Practice Dentistry Port Saint Lucie, FL

Practice location

Address: 184 NW Central Park Plz, Port Saint Lucie, FL 34986-2451
Phone: (772) 878-7348
Fax: (772) 878-7534

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence DN9155 (FL)

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Registry record

NPI: 1003016791
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jul 2007
Record last updated: 20 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.