Healthcare Provider Details

I. General information

NPI: 1306200084
Provider Name (Legal Business Name): CRYSTAL YETTER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W SCHUYLKILL RD STE G-15A
POTTSTOWN PA
19465-7438
US

IV. Provider business mailing address

351 W SCHUYLKILL RD STE G-15A
POTTSTOWN PA
19465-7438
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-9460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS041985
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: