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NPI Code Detail

MEDICARE: DR. KEITH A KRIEGEL D.D.S.

MEDICARE: DR. KEITH A KRIEGEL D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12205TX

General Provider Information

NPI Number : 1184678492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH A KRIEGEL D.D.S.
Provider Business Mailing Address
First Line : 8355 WALNUT HILL LN
Second Line : SUITE 240
City : DALLAS
State : TX
Zip : 75231-4219
Country : US
Telephone Number : 214-691-2323
Fax Number :
Provider Business Practice Location Address
First Line : 8355 WALNUT HILL LN
Second Line : SUITE 240
City : DALLAS
State : TX
Zip : 75231-4219
Country : US
Telephone Number : 214-691-2323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/08/2007

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