Provider Demographics
NPI:1629385273
Name:RILEY, SYLVIA M (DDS)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:M
Last Name:RILEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12765 MORNINGPARK CIR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7328
Mailing Address - Country:US
Mailing Address - Phone:678-860-4814
Mailing Address - Fax:
Practice Address - Street 1:12765 MORNINGPARK CIR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-7328
Practice Address - Country:US
Practice Address - Phone:678-860-4814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0141731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice