Provider Demographics
NPI:1194193722
Name:KRIEBEL AND ASSOCIATES PA
Entity type:Organization
Organization Name:KRIEBEL AND ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:KRIEBEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:252-638-1684
Mailing Address - Street 1:3680 NEUSE BLVD.
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560
Mailing Address - Country:US
Mailing Address - Phone:252-638-1864
Mailing Address - Fax:252-638-3895
Practice Address - Street 1:3680 NEUSE BLVD.
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560
Practice Address - Country:US
Practice Address - Phone:252-638-1864
Practice Address - Fax:252-638-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8078261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center