Individual
MICHAEL REGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
169 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3603
(507) 491-0126
Mailing address
169 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3603
(570) 491-0126
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D1388
SD
122300000X
Dentist
Primary
DS044530
PA
1223G0001X
General Practice Dentistry
DEN.00205219
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/03/2022
Last updated
08/29/2024
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