Individual
DR. STEPHEN J DEBUSKI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
401 W MARKET ST, POTTSVILLE, PA 17901-2930
(570) 622-2036
(570) 622-5242
Mailing address
401 W MARKET ST, POTTSVILLE, PA 17901-2930
(570) 622-2036
(570) 622-5242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
DS025974-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012759740001
—
PA
01
—
01176701
CAPITAL BLUE CROSS
PA
01
—
0609672
KEYSTONE
PA
01
—
609672
BLUE SHIELD MEDICAL
PA
Enumeration date
02/01/2006
Last updated
07/08/2007
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