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General NPI Number Information
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NPI Number | 1942504022
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Entity Type | Organization
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Legal Business Name | RIGGS DENTAL MANAGEMENT PC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 975 E RIGGS RD STE 8
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City | CHANDLER
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State | AZ
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Zip | 85249-4260
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Country | US
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Telephone | 480-802-5655
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Fax | 480-802-1233
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Provider Business Mailing Address
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Address Line | 975 E RIGGS RD STE 8
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City | CHANDLER
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State | AZ
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Zip | 85249-4260
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Country | US
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Telephone | 480-802-5655
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Fax | 480-802-1233
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | DR. ERIC LYNN KERBS
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Credential | DDS
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Telephone | 480-802-5655
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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 | 6458
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6458
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License Number State | AZ
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