Provider Demographics
NPI:1205182029
Name:RIGDEN, KATHLEEN KANE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:KANE
Last Name:RIGDEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11222 TESSON FERRY RD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6963
Mailing Address - Country:US
Mailing Address - Phone:314-849-2222
Mailing Address - Fax:
Practice Address - Street 1:11222 TESSON FERRY RD
Practice Address - Street 2:SUITE #103
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6963
Practice Address - Country:US
Practice Address - Phone:314-849-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120199011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice