Provider Demographics
NPI:1336241124
Name:CRONLEY, RICHARD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:CRONLEY
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:PO BOX 675
Mailing Address - Street 2:1020 FRANKLIN RD
Mailing Address - City:WAYNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45068
Mailing Address - Country:US
Mailing Address - Phone:513-897-2001
Mailing Address - Fax:513-897-6741
Practice Address - Street 1:1020 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45068
Practice Address - Country:US
Practice Address - Phone:513-897-2001
Practice Address - Fax:513-897-6741
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15133122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist