Organization
AMANDA RAE KRONQUIST DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA RAE KRONQUIST D.D.S. (PRESIDENT)
(714) 547-6671
Entity
Organization
Contact information
Practice address
1906 N BROADWAY, SANTA ANA, CA 92706-2610
(714) 547-6671
Mailing address
1906 N BROADWAY, SANTA ANA, CA 92706-2610
(714) 547-6671
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
64750
CA
Other
Enumeration date
09/15/2015
Last updated
07/23/2020
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