Dr Thomas N Stall Dmd Or Dr Stacy L Blackmon Dds

LBN: Lake Wylie Family Dentistry Pa
Dr Thomas N Stall Dmd Or Dr Stacy L Blackmon Dds is an health care organization with primary practice located at 1100 Village Harbor Dr , Lake Wylie SC 29710. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Lake Wylie Family Dentistry Pa can be contacted via phone (803) 831-8856, or through Stall, Susan M via phone (803) 831-8856.

Contact Information

Primary practice address
1100 Village Harbor Dr Lake Wylie SC 29710
Phone: (803) 831-8856
Fax: (803) 831-8966
Website:
Map and Directions
Authorized official contact:
Name: Stall, Susan M
Phone: (803) 831-8856

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2830 South Carolina
Dental Providers / Dentist 122300000X 3673 South Carolina

Profile Details

NPI number 1437370798
LBN Legal business name Lake Wylie Family Dentistry Pa
DBA Doing business as Dr Thomas N Stall Dmd Or Dr Stacy L Blackmon Dds
Authorized official Stall, Susan M
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2007
Last updated Feb 4th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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