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General NPI Number Information
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NPI Number | 1881135341
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Entity Type | Organization
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Legal Business Name | RYAN TIGRETT DDS PC
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 3448 VILLA LN STE 101
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City | NAPA
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State | CA
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Zip | 94558-6471
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Country | US
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Telephone | 707-265-7790
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Fax |
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Provider Business Mailing Address
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Address Line | 3448 VILLA LN STE 101
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City | NAPA
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State | CA
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Zip | 94558-6471
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Country | US
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Telephone | 707-265-7790
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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. RYAN TIGRETT
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Credential | D.D.S.
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Telephone | 301-801-5399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 59719
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License Number State | CA
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