Provider Demographics
NPI:1467422204
Name:KRIZEK, CRAIG LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:LYNN
Last Name:KRIZEK
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 1:109 N KANSAS AVE
Mailing Address - Street 2:PO BOX 386
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-2050
Mailing Address - Country:US
Mailing Address - Phone:785-877-2801
Mailing Address - Fax:785-877-2189
Practice Address - Street 1:109 N KANSAS AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-2050
Practice Address - Country:US
Practice Address - Phone:785-877-2801
Practice Address - Fax:785-877-2189
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS59081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice