Provider Demographics
NPI:1174016786
Name:STEPHANIE D SUGG DDS, PLLC
Entity Type:Organization
Organization Name:STEPHANIE D SUGG DDS, PLLC
Other - Org Name:SUGG FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-423-0091
Mailing Address - Street 1:320 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5409
Mailing Address - Country:US
Mailing Address - Phone:918-423-0091
Mailing Address - Fax:
Practice Address - Street 1:320 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5409
Practice Address - Country:US
Practice Address - Phone:918-423-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7072261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental