Jerry Lee Kronquist in Santa Ana - Oral And Maxillofacial Surgery
Jerry Lee Kronquist - NPI 1114132636
Jerry Lee Kronquist is a Oral And Maxillofacial Surgery in Santa Ana, California. Jerry Lee Kronquist practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Jerry Lee Kronquist is 1114132636. The last update date is 2022-08-11.
Jerry Lee Kronquist's current location address is 1906 N Broadway, Santa Ana, California. You can contact this provider via phone number 7145476671 and fax number 7145474385. The mailing address for Jerry Lee Kronquist is 1906 N Broadway, Santa Ana, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry Lee Kronquist |
|---|---|
| Address | 1906 N Broadway, Santa Ana, California |
| Phone Number | 7145476671 |
| Fax Number | 7145474385 |
| Sole Proprietor | Y |
| Credentials | D.D.S |
NPI Number Detail
| NPI Number | 1114132636 |
|---|---|
| Provider Enumeration Date | 2007-05-10 |
| Last Updated Date | 2022-08-11 |
Provider Mailing Address Detail
| Address | 1906 N Broadway |
|---|---|
| City | Santa Ana |
| State | California (CA) |
| Post Code | 927062610 |
| Phone Number | 7145476671 |
| Fax Number | 7145474385 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 30388 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Post Comment/ Review Below
What is the unique identifier code issued to Jerry Lee Kronquist by the Centers for Medicare & Medicaid Services (CMS)?
The Jerry Lee Kronquist has been assigned the NPI (National Provider Identifier) 1114132636. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Jerry Lee Kronquist is physically located?
The Jerry Lee Kronquist is situated at the following address: 1906 N Broadway, Santa Ana, CA 927062610.
What is Jerry Lee Kronquist's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jerry Lee Kronquist's area of specialization is Oral And Maxillofacial Surgery, and the corresponding taxonomy code that categorizes this field of practice is 1223S0112X.
On what date did the Centers for Medicare & Medicaid Services assign the 1114132636 to Jerry Lee Kronquist?
The Centers for Medicare & Medicaid Services assigned the 1114132636 to Jerry Lee Kronquist on 2007-05-10.
As of what date were the details pertaining to Jerry Lee Kronquist last refreshed?
The information related to the Jerry Lee Kronquist, including its address, specialty, and other relevant details, was last updated on 2022-08-11.