Provider Demographics
NPI:1336985019
Name:RIGGERS, GARREN (DDS)
Entity type:Individual
Prefix:DR
First Name:GARREN
Middle Name:
Last Name:RIGGERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 S SNOWFLAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4845
Mailing Address - Country:US
Mailing Address - Phone:208-602-0645
Mailing Address - Fax:
Practice Address - Street 1:2275 S EAGLE RD STE 150
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-5075
Practice Address - Country:US
Practice Address - Phone:208-888-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-56421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice