Provider Demographics
NPI:1821142852
Name:C. RIEGER WOOD, III, D.D.S., INC.
Entity Type:Organization
Organization Name:C. RIEGER WOOD, III, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHALMERS
Authorized Official - Middle Name:RIEGER
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-742-2488
Mailing Address - Street 1:3520 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-1505
Mailing Address - Country:US
Mailing Address - Phone:918-742-2488
Mailing Address - Fax:918-742-4875
Practice Address - Street 1:3520 E 31ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-1505
Practice Address - Country:US
Practice Address - Phone:918-742-2488
Practice Address - Fax:918-742-4875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK42821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty