Individual provider · NPI-1

Dr. Susan Marie Alston, D.M.D.

Dentist, General Practice · Medford, OR

NPI number1083715452
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1083715452
Entity type
Individual (NPI-1)
Name
Dr. Susan Marie Alston
Credential
D.M.D.
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 26, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeD5708ORYes

Practice location

1117 E Main St
#1
Medford, OR 97504-7404

Phone 541-779-6401 · Fax 541-608-6814

Mailing address

1117 E Main St
#1
Medford, OR 97504-7404

Phone 541-779-6401 · Fax 541-608-6814

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist, General Practice providers in Medford, OR