Provider Demographics
NPI:1437236932
Name:DRS WIGGINS AND RHODES LTD
Entity Type:Organization
Organization Name:DRS WIGGINS AND RHODES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-397-3296
Mailing Address - Street 1:1305 RODMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3916
Mailing Address - Country:US
Mailing Address - Phone:757-397-3296
Mailing Address - Fax:757-397-0893
Practice Address - Street 1:1305 RODMAN AVENUE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3916
Practice Address - Country:US
Practice Address - Phone:757-397-3296
Practice Address - Fax:757-397-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401002941122300000X
VA0401005435122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty