Healthcare Provider Details

I. General information

NPI: 1053464461
Provider Name (Legal Business Name): MICHAEL J RIGER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 W JOPPA RD SUITE 430
LUTHERVILLE MD
21093-4615
US

IV. Provider business mailing address

1209 SCOTTS KNOLL CT
LUTHERVILLE MD
21093-3739
US

V. Phone/Fax

Practice location:
  • Phone: 410-321-0505
  • Fax:
Mailing address:
  • Phone: 410-308-3856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6915
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: