Provider Demographics
NPI:1346405438
Name:TIGRETT, RYAN MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:TIGRETT
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 1:703 SARATOGA DR
Mailing Address - Street 2:APT 921
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3593
Mailing Address - Country:US
Mailing Address - Phone:301-801-5399
Mailing Address - Fax:
Practice Address - Street 1:3448 VILLA LN
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6471
Practice Address - Country:US
Practice Address - Phone:707-265-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597191223E0200X
FLDN191861223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics