| Jeffrey P Decrosta DDS PC | |
|
627 W Broad St Bethlehem PA 18018-5220 | |
| (610) 691-6200 | |
| (610) 691-1840 |
| Full Name | Jeffrey P Decrosta DDS PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 627 W Broad St, Bethlehem, Pennsylvania |
| Authorized Official Name and Position | Katharine Joan Decrosta (ADMINISTRATOR) |
| Authorized Official Contact | 6106916200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey P Decrosta DDS PC 627 W Broad St Bethlehem PA 18018-5220 Ph: (610) 691-6200 | Jeffrey P Decrosta DDS PC 627 W Broad St Bethlehem PA 18018-5220 Ph: (610) 691-6200 |
| NPI Number | 1801097811 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801097811 | NPI | - | NPPES |
| 340380 | Other | PA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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