MEDICARE: DR. MARK C RIGBY DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	23223	OH

General Provider Information

NPI Number	:	1124328398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK C RIGBY DMD

Provider Business Mailing Address
First Line	:	88 FOX TRACE LN
Second Line	:
City	:	HUDSON
State	:	OH
Zip	:	44236-3469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5706 TURNEY RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44125-3971
Country	:	US
Telephone Number	:	216-662-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	12/21/2012

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