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General NPI Number Information
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NPI Number | 1982972055
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Entity Type | Organization
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Legal Business Name | RIGDON FAMILY DENTAL, INC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 124 S BRADY ST
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City | MORGANFIELD
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State | KY
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Zip | 42437-1504
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Country | US
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Telephone | 270-389-2855
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Fax | 270-997-4856
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Provider Business Mailing Address
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Address Line | 124 S BRADY ST
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City | MORGANFIELD
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State | KY
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Zip | 42437-1504
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Country | US
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Telephone | 270-389-2855
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Fax | 270-997-4856
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Authorized Official
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Title or Position | CEO
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Name | NANCY ELIZABETH RIGDON
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Credential | DMD
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Telephone | 270-389-2855
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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 | 6889
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License Number State | KY
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