Basic Information
| Provider Information | |||||||||
| NPI: | 1528016631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRONYN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | UB ORAL & MAXILLOFACIAL SURGERY, INC | ||||||||
| Address2: | 3435 MAIN STREET 112 SQUIRE HALL | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142143001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168296637 | ||||||||
| FaxNumber: | 7168292047 | ||||||||
| Practice Location | |||||||||
| Address1: | BLDG 38717 38TH STREET | ||||||||
| Address2: | USA DENTAC | ||||||||
| City: | FT GORDON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309055660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067876927 | ||||||||
| FaxNumber: | 7067872081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 08/24/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 036799 | NY | N | Dental Providers | Dentist | General Practice | 1223S0112X | 036799 | NY | Y | Dental Providers | Dentist | Oral and Maxillofacial Surgery |
No ID Information.