Healthcare Provider Details

I. General information

NPI: 1598839326
Provider Name (Legal Business Name): RANDAL STEPHEN RIGLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 2ND AVENUE SOUTH
OKANOGAN WA
98840
US

IV. Provider business mailing address

PO BOX 1340
OKANOGAN WA
98840-1340
US

V. Phone/Fax

Practice location:
  • Phone: 509-422-5700
  • Fax:
Mailing address:
  • Phone: 509-422-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6067
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: