Provider Demographics
NPI:1447894084
Name:DR ROBERT C RIEGEL DDS APC
Entity type:Organization
Organization Name:DR ROBERT C RIEGEL DDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:REPPOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-553-5226
Mailing Address - Street 1:1016 E COOLEY DR STE F
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3961
Mailing Address - Country:US
Mailing Address - Phone:909-553-5226
Mailing Address - Fax:
Practice Address - Street 1:1016 E COOLEY DR STE F
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3961
Practice Address - Country:US
Practice Address - Phone:909-553-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental