Provider Demographics
NPI:1871084368
Name:DAYTON, REBECCA SUZANNE (MT(ASCP))
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUZANNE
Last Name:DAYTON
Suffix:
Gender:F
Credentials:MT(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BRASS RING CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3616
Mailing Address - Country:US
Mailing Address - Phone:919-815-6718
Mailing Address - Fax:
Practice Address - Street 1:550 6TH AVE N
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201-6000
Practice Address - Country:US
Practice Address - Phone:406-653-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT-180226246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist