Provider Demographics
NPI:1083841118
Name:KE DENTAL, PLLC
Entity type:Organization
Organization Name:KE DENTAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KRON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:320-252-8800
Mailing Address - Street 1:1706 11TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1200
Mailing Address - Country:US
Mailing Address - Phone:320-252-8800
Mailing Address - Fax:320-202-1014
Practice Address - Street 1:1706 11TH AVE N
Practice Address - Street 2:
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1200
Practice Address - Country:US
Practice Address - Phone:320-252-8800
Practice Address - Fax:320-202-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12650122300000X, 122300000X
MN10166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty