Provider Demographics
NPI:1033327192
Name:KROEN, GREGG RENO (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:RENO
Last Name:KROEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 HOWELL BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1005
Mailing Address - Country:US
Mailing Address - Phone:407-647-7775
Mailing Address - Fax:407-629-6499
Practice Address - Street 1:1299 HOWELL BRANCH RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1005
Practice Address - Country:US
Practice Address - Phone:407-647-7775
Practice Address - Fax:407-629-6499
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN68661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice