Provider Demographics
NPI:1679805170
Name:H L RISINGER, DDS, MDS INC.
Entity Type:Organization
Organization Name:H L RISINGER, DDS, MDS INC.
Other - Org Name:RISINGER ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:RISINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:830-257-8922
Mailing Address - Street 1:1046 GARNER FIELD RD
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4810
Mailing Address - Country:US
Mailing Address - Phone:830-278-5010
Mailing Address - Fax:830-278-4583
Practice Address - Street 1:1046 GARNER FIELD RD
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4810
Practice Address - Country:US
Practice Address - Phone:830-278-5010
Practice Address - Fax:830-278-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty