Provider Demographics
NPI:1760485551
Name:KREEB, BRYAN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:A
Last Name:KREEB
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 1:13210 ROSEDALE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-0327
Mailing Address - Country:US
Mailing Address - Phone:704-875-7200
Mailing Address - Fax:704-875-2964
Practice Address - Street 1:13210 ROSEDALE HILL AVE
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-0327
Practice Address - Country:US
Practice Address - Phone:704-875-7200
Practice Address - Fax:704-875-2964
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice