Provider Demographics
NPI:1417677816
Name:DELACRUZ, DANIELLA (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIELLA
Middle Name:
Last Name:DELACRUZ
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 1:4300 LEWISBERRY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-8387
Mailing Address - Country:US
Mailing Address - Phone:908-731-1721
Mailing Address - Fax:
Practice Address - Street 1:6837 NORMANDY ROAD
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-6022
Practice Address - Country:US
Practice Address - Phone:910-396-6602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043875122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist