Suggs, Staci

Suggs, Staci is an individual health care provider with primary practice located at 1651 Southside Connector Blvd., #1 , Jacksonville FL 32225. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Suggs, Staci can be contacted via phone (904) 821-3413.

Contact Information

Primary practice address
1651 Southside Connector Blvd., #1 Jacksonville FL 32225
Phone: (904) 821-3413
Fax: (904) 821-3418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN 15344 Florida

Profile Details

NPI number 1558477414
LBN Legal business name Suggs, Staci
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Dec 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558477414 NPPES
Florida MEDICAID 075805100
Florida Other 70050
Florida MEDICAID 075826400

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