Provider Demographics
NPI:1295116200
Name:BLANCO SANCHEZ, YOSVEL (DMD)
Entity type:Individual
Prefix:DR
First Name:YOSVEL
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 1:10250 SE 167TH PLACE RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8682
Mailing Address - Country:US
Mailing Address - Phone:352-245-0780
Mailing Address - Fax:
Practice Address - Street 1:10250 SE 167TH PLACE RD UNIT 3
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8682
Practice Address - Country:US
Practice Address - Phone:352-245-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21232122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist