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General NPI Number Information
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NPI Number | 1487752994
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Entity Type | Individual
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Provider Name | CRISTA ELAINE MASSARO D.M.D
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 3641 SAINT LAWRENCE AVE
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City | READING
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State | PA
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Zip | 19606-2326
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Country | US
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Telephone | 484-388-5600
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Fax | 484-388-5666
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Provider Business Mailing Address
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Address Line | 3641 SAINT LAWRENCE AVE
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City | READING
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State | PA
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Zip | 19606-2326
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Country | US
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Telephone | 484-388-5600
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Fax | 484-388-5666
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21167
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DS036707
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License Number State | PA
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