Provider Demographics
NPI:1558574756
Name:STIGALL, RODNEY CHRISTOPHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:CHRISTOPHER
Last Name:STIGALL
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 1:2300 CONNER RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048
Mailing Address - Country:US
Mailing Address - Phone:859-586-4825
Mailing Address - Fax:859-586-4817
Practice Address - Street 1:2300 CONNER RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048
Practice Address - Country:US
Practice Address - Phone:859-586-4825
Practice Address - Fax:859-586-4817
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY78471223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery