Melisa Susanto, DDS
NPI #1396044517 in Puyallup, Washington
Provider Information
- NPI Number
- 1396044517
- Entity Type
- Individual
- Name
- Melisa Susanto, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Pediatric Dentistry
- Credential
- DDS
- Enumeration Date
- Mar 28, 2011
- Last Updated
- Jul 28, 2014
Practice Location
- Address
- 16810 MERIDIAN E
- Address 2
- SUITE J104
- City
- Puyallup
- State
- Washington
- ZIP Code
- 98375-9604
- Phone
- (626) 241-2669
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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