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General NPI Number Information
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NPI Number | 1174016786
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Entity Type | Organization
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Legal Business Name | STEPHANIE D SUGG DDS, PLLC
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 06/08/2018
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Provider Practice Location Address
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Address Line | 320 S 4TH ST
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City | MCALESTER
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State | OK
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Zip | 74501-5409
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Country | US
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Telephone | 918-423-0091
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Fax |
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Provider Business Mailing Address
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Address Line | 320 S 4TH ST
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City | MCALESTER
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State | OK
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Zip | 74501-5409
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Country | US
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Telephone | 918-423-0091
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. STEPHANIE D SUGG
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Credential | DDS
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Telephone | 918-423-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7072
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License Number State | OK
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