Provider Demographics
NPI:1043317852
Name:CRONIN, ROBERT J JR (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:CRONIN
Suffix:JR
Gender:M
Credentials:DDS MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 40397
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3900
Mailing Address - Country:US
Mailing Address - Phone:210-567-6405
Mailing Address - Fax:210-567-2844
Practice Address - Street 1:7703 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-567-6405
Practice Address - Fax:210-567-2844
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXTX170121223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
82H263OtherBLUE CROSS BLUE SHIELD
819382OtherUNITED CONCORDIA
819382OtherUNITED CONCORDIA
82H263Medicare ID - Type Unspecified