Provider Demographics
NPI:1285810713
Name:STAGG, CLAIRE E (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:E
Last Name:STAGG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 HWY A1A
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4924
Mailing Address - Country:US
Mailing Address - Phone:321-777-2797
Mailing Address - Fax:321-777-6887
Practice Address - Street 1:2120 HWY A1A
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4924
Practice Address - Country:US
Practice Address - Phone:321-777-2797
Practice Address - Fax:321-777-6887
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN120781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice