Provider Demographics
NPI:1396007340
Name:CRONLY, JO KOONTZ (DDS)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:KOONTZ
Last Name:CRONLY
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:2400 COLONY CROSSING PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4281
Mailing Address - Country:US
Mailing Address - Phone:804-639-6445
Mailing Address - Fax:804-639-6400
Practice Address - Street 1:2400 COLONY CROSSING PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4281
Practice Address - Country:US
Practice Address - Phone:804-639-6445
Practice Address - Fax:804-639-6400
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2017-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA04014136371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry