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General NPI Number Information
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NPI Number | 1255994828
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL CRONIN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 112 LAMAR BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-8147
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Country | US
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Telephone | 601-450-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 MONTFORT LOOP
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City | RICHMOND
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State | VA
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Zip | 23294-5235
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Country | US
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Telephone | 801-857-8311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4115-20
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License Number State | MS
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