Provider Demographics
NPI:1154594182
Name:KRIGER, MARYANN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARYANN
Middle Name:
Last Name:KRIGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27970 CROWN LAKE BLVD
Mailing Address - Street 2:#2
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4255
Mailing Address - Country:US
Mailing Address - Phone:239-947-1235
Mailing Address - Fax:239-949-2099
Practice Address - Street 1:27970 CROWN LAKE BLVD
Practice Address - Street 2:#2
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4255
Practice Address - Country:US
Practice Address - Phone:239-947-1235
Practice Address - Fax:239-949-2099
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 167641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics