Organization
GREEN GABLES DENTAL LLC
Active
Other names
Michael Riggs
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RIGGS (OWNER)
(720) 442-8256
Entity
Organization
Contact information
Practice address
7586 W JEWELL AVE # 2-303, LAKEWOOD, CO 80232-6890
(720) 442-8256
(720) 442-8246
Mailing address
7586 W JEWELL AVE # 2-303, LAKEWOOD, CO 80232-6890
(720) 442-8256
(720) 442-8246
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00202170
CO
1223D0004X
Dental Anesthesiology
Primary
00202170
CO
1223D0004X
Dental Anesthesiology
02786101
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174698666
—
CO
Enumeration date
10/11/2017
Last updated
11/22/2017
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