Individual
SUZANNE R. MERICLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
123 MAIN ST, SAINT SIMONS ISLAND, GA 31522-1680
(912) 638-3559
(912) 638-0360
Mailing address
123 MAIN ST, SAINT SIMONS ISLAND, GA 31522-1680
(912) 638-3559
(912) 638-0360
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000484294A
—
GA
Enumeration date
12/05/2006
Last updated
03/05/2020
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