MEDICARE: DR. AMY LYNN RIGBY D.D.S.

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	1223G0001X	General Practice Dentistry	22256	TX

General Provider Information

NPI Number	:	1922122670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY LYNN RIGBY D.D.S.

Provider Business Mailing Address
First Line	:	4560 W MOCKINGBIRD LN STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209
Country	:	US
Telephone Number	:	214-904-1000
Fax Number	:	214-904-1002

Provider Business Practice Location Address
First Line	:	4560 W MOCKINGBIRD LN STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209
Country	:	US
Telephone Number	:	214-904-1000
Fax Number	:	214-904-1002

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	04/16/2010

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