Provider Demographics
NPI:1497888200
Name:RIGDON, TERRY F (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:F
Last Name:RIGDON
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 1:6030 S 66TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-9236
Mailing Address - Country:US
Mailing Address - Phone:918-494-8666
Mailing Address - Fax:918-494-6702
Practice Address - Street 1:6030 S 66TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9236
Practice Address - Country:US
Practice Address - Phone:918-494-8666
Practice Address - Fax:918-494-6702
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK45661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice