# ALLEN FOREST CROOMS DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598880296
- **Authorized official:** DR. ALLEN FOREST CROOMS DDS PA (PRESIDENT TREASURER)
- **Authorized official phone:** (973) 824-9085

## Contact information

- **Practice address:** 814 SOUTH TENTH STREET, NEWARK, NJ 07108-1501
- **Practice address phone:** (973) 824-9085
- **Practice address fax:** (973) 621-6447
- **Mailing address:** 814 SOUTH TENTH STREET, NEWARK, NJ 07108-1501
- **Mailing address phone:** (973) 824-9085
- **Mailing address fax:** (973) 621-6447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22D100662900 | NJ | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1009778 | HORIZON BCBS | NJ |
| 01 | — | 111225 | AETNA DMO | NJ |
| 05 | — | 2688808 | — | NJ |