MEDICARE: DR. ROBERT L. CRONYN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0004X	Dental Anesthesiology	001117	NY
2	1223G0001X	General Practice Dentistry	036799	NY
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	036799	NY
4	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	036799	NY

General Provider Information

NPI Number	:	1528016631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L. CRONYN DDS

Provider Business Mailing Address
First Line	:	UB ORAL & MAXILLOFACIAL SURGERY, INC
Second Line	:	3435 MAIN STREET 112 SQUIRE HALL
City	:	BUFFALO
State	:	NY
Zip	:	14214-3001
Country	:	US
Telephone Number	:	716-829-6637
Fax Number	:	716-829-2047

Provider Business Practice Location Address
First Line	:	3435 MAIN ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14214-3001
Country	:	US
Telephone Number	:	716-899-6637
Fax Number	:	706-787-2081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	09/20/2024

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