Provider Demographics
NPI:1588349658
Name:KRYGIER, BROCK (DDS)
Entity type:Individual
Prefix:DR
First Name:BROCK
Middle Name:
Last Name:KRYGIER
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 1:23946 WINTERGREEN CIR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3681
Mailing Address - Country:US
Mailing Address - Phone:248-978-4749
Mailing Address - Fax:
Practice Address - Street 1:5080 W BRISTOL RD STE 200
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2923
Practice Address - Country:US
Practice Address - Phone:248-978-4749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601733122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist