Individual
DR. STACI SUGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1651 SOUTHSIDE CONNECTOR BLVD., #1, JACKSONVILLE, FL 32225
(904) 821-3413
(904) 821-3418
Mailing address
1651 SOUTHSIDE CONNECTOR BLVD., #1, JACKSONVILLE, FL 32225
(904) 821-3413
(904) 821-3418
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN 15344
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075805100
—
FL
05
—
075826400
—
FL
01
—
70050
ADI HEALTHY KIDS
FL
Enumeration date
08/22/2006
Last updated
12/21/2018
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