Provider Demographics
NPI:1184678492
Name:KRIEGEL, KEITH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:KRIEGEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8355 WALNUT HILL LN
Mailing Address - Street 2:SUITE 240
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4219
Mailing Address - Country:US
Mailing Address - Phone:214-691-2323
Mailing Address - Fax:
Practice Address - Street 1:8355 WALNUT HILL LN
Practice Address - Street 2:SUITE 240
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4219
Practice Address - Country:US
Practice Address - Phone:214-691-2323
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice