Organization
JEFFREY P DECROSTA DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHARINE JOAN DECROSTA (ADMINISTRATOR)
(610) 691-6200
Entity
Organization
Contact information
Practice address
627 W BROAD ST, BETHLEHEM, PA 18018-5220
(610) 691-6200
(610) 691-1840
Mailing address
627 W BROAD ST, BETHLEHEM, PA 18018-5220
(610) 691-6200
(610) 691-1840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340380
UNITED CONCORDIA
PA
Enumeration date
05/29/2007
Last updated
08/22/2020
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