Provider Demographics
NPI:1770131534
Name:ROBERT C. RIEGEL, D.D.S APC
Entity type:Organization
Organization Name:ROBERT C. RIEGEL, D.D.S APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-436-6186
Mailing Address - Street 1:3663 E SUNSET RD STE 507
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3299
Mailing Address - Country:US
Mailing Address - Phone:702-436-6186
Mailing Address - Fax:702-436-3276
Practice Address - Street 1:3663 E SUNSET RD STE 507
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3299
Practice Address - Country:US
Practice Address - Phone:702-436-6186
Practice Address - Fax:702-436-3276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental