Provider Demographics
NPI:1487752994
Name:MASSARO, CRISTA ELAINE (DMD)
Entity type:Individual
Prefix:DR
First Name:CRISTA
Middle Name:ELAINE
Last Name:MASSARO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 SAINT LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2326
Mailing Address - Country:US
Mailing Address - Phone:484-388-5600
Mailing Address - Fax:484-388-5666
Practice Address - Street 1:3641 SAINT LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2326
Practice Address - Country:US
Practice Address - Phone:484-388-5600
Practice Address - Fax:484-388-5666
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21167122300000X
PADS0367071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist