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NPI Code Detail

MEDICARE: DR. JENNIFER KRONBERG HORTON D.D.S., M.S.D

MEDICARE: DR. JENNIFER KRONBERG HORTON D.D.S., M.S.D
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry2006037320MO

General Provider Information

NPI Number : 1619020336
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER KRONBERG HORTON D.D.S., M.S.D
Provider Business Mailing Address
First Line : 1185 CAVE SPRINGS ESTATE DR
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-6529
Country : US
Telephone Number : 636-757-1800
Fax Number :
Provider Business Practice Location Address
First Line : 1185 CAVE SPRINGS ESTATE DR
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-6529
Country : US
Telephone Number : 636-757-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 07/08/2007

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