Provider Demographics
NPI:1235543521
Name:SUGGS, JESSIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:
Last Name:SUGGS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-2160
Mailing Address - Country:US
Mailing Address - Phone:843-563-3208
Mailing Address - Fax:
Practice Address - Street 1:102 BRYANT ST
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:SC
Practice Address - Zip Code:29477-2160
Practice Address - Country:US
Practice Address - Phone:843-563-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice