Healthcare Provider Details

I. General information

NPI: 1225102312
Provider Name (Legal Business Name): RICHARD LAWRENCE KRONZER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W SUPERIOR ST SUITE 530
DULUTH MN
55802-1701
US

IV. Provider business mailing address

9450 E BOULDER DR
SOLON SPRINGS WI
54873-8444
US

V. Phone/Fax

Practice location:
  • Phone: 218-727-7557
  • Fax: 218-727-1182
Mailing address:
  • Phone: 715-378-2200
  • Fax: 218-727-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberD8723
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: