Provider Demographics
NPI:1538210174
Name:RIGGS, CRYSTEL ANANOS (DMD)
Entity type:Individual
Prefix:DR
First Name:CRYSTEL
Middle Name:ANANOS
Last Name:RIGGS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SE OCEAN BLVD
Mailing Address - Street 2:SUITE 248
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2471
Mailing Address - Country:US
Mailing Address - Phone:772-220-4171
Mailing Address - Fax:772-781-3913
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:SUITE 248
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-220-4171
Practice Address - Fax:772-781-3913
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist