Individual
DR. ERICA DANIELLE CROSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
929 SW SIMPSON AVE, BEND, OR 97702-3599
(541) 848-6642
Mailing address
929 SW SIMPSON AVE, BEND, OR 97702-3599
(541) 848-6642
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
LL-371-14
NV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D10528
OR
Other
Enumeration date
07/29/2014
Last updated
01/05/2017
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