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Melisa Susanto, DDS
NPI 1396044517 · on the registry since 2011
Practice
- Address
- 16810 Meridian E
Suite J104
Puyallup, WA 98375 - Phone
- (626) 241-2669
- Organisation at this address
- Washington Dental Corporation Pc
Washington Dental Corporation, PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 14
Registry record
- Primary taxonomy
- Pediatric Dentistry
1223P0221X
- Also registered as
- General Practice Dentistry
- Licence states on file
- MI, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-07-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington