Organization
ALLEN FOREST CROOMS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN FOREST CROOMS DDS PA (PRESIDENT TREASURER)
(973) 824-9085
Entity
Organization
Contact information
Practice address
814 SOUTH TENTH STREET, NEWARK, NJ 07108-1501
(973) 824-9085
(973) 621-6447
Mailing address
814 SOUTH TENTH STREET, NEWARK, NJ 07108-1501
(973) 824-9085
(973) 621-6447
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D100662900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009778
HORIZON BCBS
NJ
01
—
111225
AETNA DMO
NJ
05
—
2688808
—
NJ
Enumeration date
03/20/2007
Last updated
08/22/2020
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