Provider Demographics
NPI:1821438722
Name:STURGILL, RILEY BETH (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:RILEY
Middle Name:BETH
Last Name:STURGILL
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:MISS
Other - First Name:RILEY
Other - Middle Name:BETH
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 HARBOR APPROACH
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3150
Mailing Address - Country:US
Mailing Address - Phone:423-767-9540
Mailing Address - Fax:
Practice Address - Street 1:2800 PEOPLES ST STE 60
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4158
Practice Address - Country:US
Practice Address - Phone:423-930-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN105921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty