Most Relevant Information
Provider Data
| NPI Number: | 1003016791 |
| Provider Name: | STEPHEN GARY BLANK DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | DN9155 |
Most Important Dates
| Enumeration Date: | 07/20/2007 |
| Last Updated: | 07/20/2007 |
Provider Practice Location
184 NW CENTRAL PARK PLZ
PORT SAINT LUCIE
FL
349862451
Practice Location Phone/Fax
| Phone: | 7728787348 |
| Fax: | 7728787534 |
Provider Mailing Location
184 NW CENTRAL PARK PLZ
PORT SAINT LUCIE
FL
349862451
Provider Mailing Phone/Fax
| Phone: | 7728787348 |
| Fax: | 7728787534 |