Provider Demographics
NPI:1801969530
Name:RIGGS, GARY L (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:RIGGS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1820 SHEEDER MILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475-9537
Mailing Address - Country:US
Mailing Address - Phone:610-469-6576
Mailing Address - Fax:610-889-7547
Practice Address - Street 1:72 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1831
Practice Address - Country:US
Practice Address - Phone:610-647-1666
Practice Address - Fax:610-889-7547
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015941122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist