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General NPI Number Information
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NPI Number | 1669888673
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Entity Type | Organization
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Legal Business Name | DENTISTRY BY JORDAN RIGSBY, DMD, PA
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 2274 WEDNESDAY ST
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City | TALLAHASSEE
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State | FL
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Zip | 32308-8308
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Country | US
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Telephone | 850-309-0970
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Fax |
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Provider Business Mailing Address
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Address Line | 2274 WEDNESDAY ST
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City | TALLAHASSEE
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State | FL
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Zip | 32308-8308
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Country | US
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Telephone | 850-309-0970
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORDAN R RIGSBY
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Credential | DMD
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Telephone | 850-309-0970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20194
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License Number State | FL
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