Provider Demographics
NPI:1669119749
Name:KRONI, MARCEL (DDS)
Entity type:Individual
Prefix:
First Name:MARCEL
Middle Name:
Last Name:KRONI
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 1:47354 STEPHANIE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4831
Mailing Address - Country:US
Mailing Address - Phone:586-770-1899
Mailing Address - Fax:
Practice Address - Street 1:3115 N HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-1602
Practice Address - Country:US
Practice Address - Phone:314-451-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022017695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist