Healthcare Provider Details

I. General information

NPI: 1083841118
Provider Name (Legal Business Name): KE DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 02/27/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 11TH AVE N
ST. CLOUD MN
56303-1200
US

IV. Provider business mailing address

1706 11TH AVE N
ST. CLOUD MN
56303-1200
US

V. Phone/Fax

Practice location:
  • Phone: 320-252-8800
  • Fax: 320-202-1014
Mailing address:
  • Phone: 320-252-8800
  • Fax: 320-202-1014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD12650
License Number StateMN

VIII. Authorized Official

Name: STEVEN JAMES KRON JR.
Title or Position: OWNER/DENTIST
Credential: D.D.S.
Phone: 320-252-8800