Kenneth Detlaf Cross, DMD is a medicare enrolled "Dentist" provider in Benton, Pennsylvania. His current practice location is
510 Main St, Benton, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(570) 925-5011.
Kenneth Detlaf Cross is licensed to practice in Pennsylvania (license number DS026724L) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1982717328.
Healthcare Provider's Profile
Full Name | Kenneth Detlaf Cross |
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Gender | Male |
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Speciality | Dentist |
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Location | 510 Main St, Benton, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1982717328
- Provider Enumeration Date: 08/17/2006
- Last Update Date: 04/03/2016
Medicare PECOS Information:
- PECOS PAC ID: 1850695883
- Enrollment ID: I20160211000259
Medical Identifiers
Medical identifiers for Kenneth Detlaf Cross such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982717328 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | DS026724L (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Detlaf Cross is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kenneth Detlaf Cross, DMD Po Box 248, 510 Main St, Benton, PA 17814 Ph: (570) 925-5011 | Kenneth Detlaf Cross, DMD 510 Main St, Benton, PA 17814 Ph: (570) 925-5011 |
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