Provider Demographics
NPI:1528016631
Name:CRONYN, ROBERT L (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:CRONYN
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:UB ORAL & MAXILLOFACIAL SURGERY, INC
Mailing Address - Street 2:3435 MAIN STREET 112 SQUIRE HALL
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-3001
Mailing Address - Country:US
Mailing Address - Phone:716-829-6637
Mailing Address - Fax:716-829-2047
Practice Address - Street 1:BLDG 38717 38TH STREET
Practice Address - Street 2:USA DENTAC
Practice Address - City:FT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5660
Practice Address - Country:US
Practice Address - Phone:706-787-6927
Practice Address - Fax:706-787-2081
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0367991223G0001X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice