Healthcare Provider Details

I. General information

NPI: 1487304820
Provider Name (Legal Business Name): REBECCA ANNE SALUSTRI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 EDEN RD
LANCASTER PA
17601-4700
US

IV. Provider business mailing address

700 EDEN RD
LANCASTER PA
17601-4700
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-6487
  • Fax: 717-581-5487
Mailing address:
  • Phone: 717-569-6487
  • Fax: 717-581-5487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS045619
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: