Provider Demographics
NPI:1265901409
Name:RIGGS, MAE SUE (RDH)
Entity type:Individual
Prefix:
First Name:MAE SUE
Middle Name:
Last Name:RIGGS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MAE SUE
Other - Middle Name:
Other - Last Name:REKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:1117 CHOPMIST HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1047
Mailing Address - Country:US
Mailing Address - Phone:401-497-0574
Mailing Address - Fax:
Practice Address - Street 1:25 JOHN A CUMMINGS WAY
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3244
Practice Address - Country:US
Practice Address - Phone:401-767-4161
Practice Address - Fax:401-767-5441
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDH01610124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist