Individual
DR. JONPAUL VANREGENMORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1359 MAIN RD, TIVERTON, RI 02878-4426
(401) 624-9177
(401) 624-9233
Mailing address
25 HIGHLAND RD, TIVERTON, RI 02878-4409
(401) 624-6119
(401) 624-9233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN02748
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80945
BLUE CROSS BLUE SHIELD
RI
01
—
X12325
BLUE COSS BLUE SHIELD
MA
Enumeration date
09/15/2006
Last updated
07/08/2007
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