Provider Demographics
NPI:1992852610
Name:KROST, BRIAN S (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:KROST
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 CRIMSON CIR
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1658
Mailing Address - Country:US
Mailing Address - Phone:732-229-6819
Mailing Address - Fax:
Practice Address - Street 1:1125 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4043
Practice Address - Country:US
Practice Address - Phone:732-531-8700
Practice Address - Fax:732-531-8775
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0172531223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKR440370Medicare ID - Type Unspecified
NJU52336Medicare UPIN