Provider Demographics
NPI:1578650032
Name:RYGG PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:RYGG PROFESSIONAL DENTAL CORPORATION
Other - Org Name:PACIFIC DENTAL GROUP OF EL CAJON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:RYGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-447-3100
Mailing Address - Street 1:2860 MICHELLE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1009
Mailing Address - Country:US
Mailing Address - Phone:714-508-3600
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:895 JACKMAN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3052
Practice Address - Country:US
Practice Address - Phone:619-447-3100
Practice Address - Fax:619-447-3107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty