NPI 1083715452 · live from the CMS NPI Registry
Susan Marie Alston, D.M.D.
Dentist, General Practice in Medford, OR. National Provider Identifier 1083715452, active.
NPI record
| NPI | 1083715452 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 1117 E Main St, #1, Medford, OR 97504 |
| Practice phone | 541-779-6401 |
| Enumerated | September 26, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | D5708 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.