Organization
PEDIATRIC SMILES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACI SUGGS D.D.S. (OWNER/DENTIST)
(904) 751-5126
Entity
Organization
Contact information
Practice address
2262 DUNN AVE, STE 4, JACKSONVILLE, FL 32218
(904) 751-5126
(904) 751-5146
Mailing address
PO BOX 26701, JACKSONVILLE, FL 32226-6701
(904) 751-5126
(904) 751-5146
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN 15344
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70084
ADI HEALTHY KIDS
FL
Enumeration date
08/24/2006
Last updated
08/22/2020
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