Provider Demographics
NPI:1467211565
Name:ROMANCZUK, KRISTINA (PHDH)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:ROMANCZUK
Suffix:
Gender:F
Credentials:PHDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 3RD ST STE 260
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-2072
Mailing Address - Country:US
Mailing Address - Phone:484-526-2460
Mailing Address - Fax:
Practice Address - Street 1:511 E 3RD ST STE 260
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-2072
Practice Address - Country:US
Practice Address - Phone:484-526-2460
Practice Address - Fax:484-526-2466
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH000944124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist