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NPI Code Detail

MEDICARE: ROBERT C RIEGEL DDS-MS A PROFESSIONAL CORPORATION

MEDICARE: ROBERT C RIEGEL DDS-MS A PROFESSIONAL CORPORATION
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
1122300000XDentistCS09906NV

General Provider Information

NPI Number : 1518340017
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT C RIEGEL DDS-MS A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 5642 S EASTERN AVE
Second Line : STE B
City : LAS VEGAS
State : NV
Zip : 89119-2375
Country : US
Telephone Number : 702-436-6186
Fax Number : 702-436-3276
Provider Business Practice Location Address
First Line : 5642 S EASTERN AVE
Second Line : STE B
City : LAS VEGAS
State : NV
Zip : 89119-2375
Country : US
Telephone Number : 702-436-6186
Fax Number : 702-436-3276
Authorized Official
Title or Position : OWNER
Name : DR. ROBERT C RIEGEL
Credential : DDS
Telephone Number : 702-436-6186
Provider Enumeration Date : 07/01/2015
Last Update Date : 07/01/2015

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