Provider Demographics
NPI:1750273272
Name:KITTLE, BROCK ROBERT (DDS)
Entity type:Individual
Prefix:
First Name:BROCK
Middle Name:ROBERT
Last Name:KITTLE
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 1:802 ARBORDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4624
Mailing Address - Country:US
Mailing Address - Phone:334-707-0398
Mailing Address - Fax:
Practice Address - Street 1:965 S POINT RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-9520
Practice Address - Country:US
Practice Address - Phone:704-800-4009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC143271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice