| NPI | 1114307899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RIGGS Owner 917-340-0642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO 00202170) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |