Provider Demographics
NPI:1710908561
Name:RIGGINS, THOMAS VALTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VALTON
Last Name:RIGGINS
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 1:157 E NEW ENGLAND AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4346
Mailing Address - Country:US
Mailing Address - Phone:407-645-0404
Mailing Address - Fax:
Practice Address - Street 1:157 E NEW ENGLAND AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4346
Practice Address - Country:US
Practice Address - Phone:407-645-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice