Provider Demographics
NPI:1851412688
Name:DANIEL E. CRONK DDS INC.
Entity Type:Organization
Organization Name:DANIEL E. CRONK DDS INC.
Other - Org Name:AESTHETIC DENTISTRY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:CRONK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-224-2001
Mailing Address - Street 1:23111 VENTURA BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364
Mailing Address - Country:US
Mailing Address - Phone:818-224-2001
Mailing Address - Fax:818-224-4622
Practice Address - Street 1:23111 VENTURA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1103
Practice Address - Country:US
Practice Address - Phone:818-224-2001
Practice Address - Fax:818-224-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA397811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty