| NPI | 1912014937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI SUGGS Owner/Dentist 904-751-5126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL dn 15344) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |