Organization
SUZANNE R. MERICLE, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE R. MERICLE DMD (OWNER/DENTIST)
(912) 638-3559
Entity
Organization
Contact information
Practice address
123 MAIN ST, ST SIMONS ISLAND, GA 31522-1680
(912) 638-3559
(912) 638-0360
Mailing address
123 MAIN ST, ST SIMONS ISLAND, GA 31522-1680
(912) 638-3559
(912) 638-0360
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
011052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000484294A
—
GA
Enumeration date
05/14/2014
Last updated
03/05/2020
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