Provider Demographics
NPI:1699941724
Name:TERRY F. RIGDON, DDS, PC
Entity type:Organization
Organization Name:TERRY F. RIGDON, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:RIGDON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-494-8666
Mailing Address - Street 1:6030 S 66TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-9236
Mailing Address - Country:US
Mailing Address - Phone:918-494-8666
Mailing Address - Fax:918-494-6702
Practice Address - Street 1:6030 S 66TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9236
Practice Address - Country:US
Practice Address - Phone:918-494-8666
Practice Address - Fax:918-494-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty