Provider Demographics
NPI:1871640623
Name:TIGGES, CATHY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:C
Last Name:TIGGES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2507
Mailing Address - Country:US
Mailing Address - Phone:712-792-4375
Mailing Address - Fax:712-792-3371
Practice Address - Street 1:522 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2507
Practice Address - Country:US
Practice Address - Phone:712-792-4375
Practice Address - Fax:712-792-3371
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA07656122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06729OtherBLUECROSS BLUESHIELD ID #
IA180751OtherUNITED CONCORDIA ID #
IA1196030Medicaid