Provider Demographics
NPI:1083907828
Name:RIYAL, TARIQ (DDS)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:
Last Name:RIYAL
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 1:201 HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-3289
Mailing Address - Country:US
Mailing Address - Phone:630-863-8342
Mailing Address - Fax:
Practice Address - Street 1:201 HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-3289
Practice Address - Country:US
Practice Address - Phone:630-863-8342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190286011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice