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Melisa Susanto, DDS
Pediatric Dentist in Puyallup, Washington
NPI 1396044517

Melisa Susanto is a Pediatric Dentist based in Puyallup, WA and is specialized in Pediatric Dentistry. Melisa Susanto practices in Puyallup, WA and has the professional credentials of DDS. The NPI Number for Melisa Susanto is 1396044517 and holds a License No. 2901020349 (Washington).

The current practice location address for Melisa Susanto is 16810 Meridian E, Puyallup, WA and can be reached out via phone at 626-241-2669. You can also correspond with Melisa Susanto through the mailing address at 16810 MERIDIAN E, PUYALLUP, WA - 98375-9604 (mailing address contact number: 626-241-2669).

Location: 16810 Meridian E, Puyallup, WA, 98375-9604
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396044517
Provider Name
Melisa Susanto
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
16810 Meridian E, Puyallup, WA, 98375-9604
Phone Number
626-241-2669
Fax Number
Provider Enumeration Date
03/28/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
16810 Meridian E
City
Puyallup
State
Washington
Zip
98375-9604
Phone Number
626-241-2669
Fax Number
person
Provider Business Mailing Address Details
Address
16810 Meridian E
City
Puyallup
State
Washington
Zip
98375-9604
Phone Number
626-241-2669
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DE60481607 (Washington)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2901020349 (Michigan)
Definition
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.
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