Individual
DR. JERRY LEE KRONQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1906 N . BROADWAY, SANTA ANA, CA 92706-2610
(714) 547-6671
(714) 547-4385
Mailing address
1906 N BROADWAY, SANTA ANA, CA 92706-2610
(714) 547-6671
(714) 547-4385
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30388
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30388
CA
Other
Enumeration date
05/10/2007
Last updated
08/11/2022
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