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General NPI Number Information
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NPI Number | 1457532368
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Entity Type | Organization
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Legal Business Name | CARL R KRIEBEL, DMD, PA
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 3847 HENDERSON DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-5228
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Country | US
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Telephone | 910-219-4400
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Fax | 910-346-7292
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Provider Business Mailing Address
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Address Line | 3847 HENDERSON DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-5228
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Country | US
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Telephone | 910-219-4400
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Fax | 910-346-7292
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARL R KRIEBEL JR.
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Credential | D.M.D.
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Telephone | 910-219-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8078
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License Number State | NC
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