Individual provider · Type 1 NPI
Melisa Susanto, DDS
Pediatric Dentistry · Puyallup, WA
NPI number
1396044517
Active
Practice location
16810 Meridian E, Suite J104
Puyallup, WA 98375-9604
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901020349 (MI) |
| Pediatric Dentistry Primary | 1223P0221X | DE60481607 (WA) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
2 other providers at this address
Other pediatric dentistry providers in Puyallup
About NPI 1396044517
Melisa Susanto, DDS's National Provider Identifier is 1396044517, issued on Mar 28, 2011. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Puyallup, WA. The record was last updated on Jul 28, 2014.