Individual
KENNETH DETLAF CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
510 MAIN ST, BENTON, PA 17814
(570) 925-5011
(570) 925-2943
Mailing address
PO BOX 248, 510 MAIN ST, BENTON, PA 17814
(570) 925-5011
(570) 925-2943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS026724L
PA
Other
Enumeration date
08/17/2006
Last updated
04/03/2016
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