Provider Demographics
NPI:1457532368
Name:CARL R KRIEBEL, DMD, PA
Entity Type:Organization
Organization Name:CARL R KRIEBEL, DMD, PA
Other - Org Name:ABSOLUTELY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRIEBEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:910-219-4400
Mailing Address - Street 1:3847 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5228
Mailing Address - Country:US
Mailing Address - Phone:910-219-4400
Mailing Address - Fax:910-346-7292
Practice Address - Street 1:3847 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5228
Practice Address - Country:US
Practice Address - Phone:910-219-4400
Practice Address - Fax:910-346-7292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8078122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty