Provider Demographics
NPI:1427452309
Name:CHIMNEY HILLS DENTAL
Entity type:Organization
Organization Name:CHIMNEY HILLS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-492-0412
Mailing Address - Street 1:7901 S SHERIDAN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-8900
Mailing Address - Country:US
Mailing Address - Phone:918-492-0412
Mailing Address - Fax:
Practice Address - Street 1:7901 S SHERIDAN RD
Practice Address - Street 2:SUITE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-8900
Practice Address - Country:US
Practice Address - Phone:918-492-0412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty