Provider Demographics
NPI:1518962125
Name:RIFORGIATE, ANTHONY F (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:RIFORGIATE
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 1:504 E CHURCH ST
Mailing Address - Street 2:STE A
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5263
Mailing Address - Country:US
Mailing Address - Phone:805-925-1781
Mailing Address - Fax:805-925-8971
Practice Address - Street 1:504 E CHURCH ST
Practice Address - Street 2:STE A
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5263
Practice Address - Country:US
Practice Address - Phone:805-925-1781
Practice Address - Fax:805-925-8971
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA237721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA860796OtherUNITED CONCORDIA
CAB23372-01Medicaid