IndividualActive
Kelton Cronquist, DMD, MS
NPI 1417701400 · Orthodontics and Dentofacial Orthopedics Dentistry · Meridian, ID
Provider details
- NPI number
- 1417701400
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DMD, MS
- Sex
- Male
- Sole proprietor
- No
- License
- D-5605 (ID)
Specialties & taxonomies
Dental Providers
Practice location
1200 W Cherry Ln
Meridian, ID 83642-4930
Phone: (208) 898-0000
Approximate (ZIP-level) locationGet directions
Mailing address
840 N Tullshire Way
Eagle, ID 83616-3305
Registry dates
- Enumerated
- 2024-04-16
- Last updated
- 2024-04-16
- Certified
- 2024-04-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.