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NPI 1891855060

NPI 1891855060 : CARL R KRIEBEL JR. DMD : JACKSONVILLE, NC

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General NPI Number Information
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    NPI Number           |    1891855060
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    Entity Type          |    Individual 
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    Provider Name        |    CARL R KRIEBEL JR. DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2006
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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         |    280 HUFFMANTOWN RD 
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    City                 |    RICHLANDS
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    State                |    NC
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    Zip                  |    28574-6206
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    Country              |    US
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    Telephone            |    910-581-1544
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    Fax                  |    910-346-7292
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    8078
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    License Number State |    NC
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