Provider Demographics
NPI:1255305348
Name:RIGGS, JR., GARY A (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:A
Last Name:RIGGS, JR.
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 1:1610 ABERDEEN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3145
Mailing Address - Country:US
Mailing Address - Phone:757-838-3830
Mailing Address - Fax:757-838-4331
Practice Address - Street 1:1610 ABERDEEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3145
Practice Address - Country:US
Practice Address - Phone:757-838-3830
Practice Address - Fax:757-838-4331
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010073731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics