Provider Demographics
NPI:1003950064
Name:KRON, JENNIFER I (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:I
Last Name:KRON
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 1:3018 CHARLESTOWN CROSSING
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-0001
Mailing Address - Country:US
Mailing Address - Phone:812-945-3636
Mailing Address - Fax:
Practice Address - Street 1:3018 CHARLESTOWN CROSSING
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-0001
Practice Address - Country:US
Practice Address - Phone:812-945-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY81011223E0200X
IN12010906A1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics