Provider Demographics
NPI:1235580358
Name:RIGG, ALEJANDRO LUIS (DMD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:LUIS
Last Name:RIGG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BALABAN CIR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5150
Mailing Address - Country:US
Mailing Address - Phone:404-247-9004
Mailing Address - Fax:
Practice Address - Street 1:7840 HICKORY FLAT HWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-2099
Practice Address - Country:US
Practice Address - Phone:770-479-8457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist