Provider Demographics
NPI:1790985067
Name:RIEGER, ERIC R (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:RIEGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 SHERIDAN ST
Mailing Address - Street 2:APT. B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3552
Mailing Address - Country:US
Mailing Address - Phone:954-966-6352
Mailing Address - Fax:
Practice Address - Street 1:4420 SHERIDAN ST
Practice Address - Street 2:APT. B
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3552
Practice Address - Country:US
Practice Address - Phone:954-966-6352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00123941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice