Provider Demographics
NPI:1790466126
Name:BLANCO SANCHEZ, YOAN (DMD)
Entity Type:Individual
Prefix:
First Name:YOAN
Middle Name:
Last Name:BLANCO SANCHEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SE 16TH PL APT 1
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1310
Mailing Address - Country:US
Mailing Address - Phone:239-384-2056
Mailing Address - Fax:
Practice Address - Street 1:47 BARKLEY CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7734
Practice Address - Country:US
Practice Address - Phone:239-542-3925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL284701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice