Individual
MANIVARA P KRONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3004 HIGHWAY 121, SUITE B, BEDFORD, TX 76021-4088
(817) 283-8600
(817) 283-8621
Mailing address
1204 DEL MAR DR, SOUTHLAKE, TX 76092-3931
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20602
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148216803
—
TX
Enumeration date
08/22/2006
Last updated
06/08/2008
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