Individual
DR. TARA LYNN REGENOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4800 NICOLLET AVE, MINNEAPOLIS, MN 55419-5511
(612) 822-2176
Mailing address
5401 WENTWORTH AVE, MINNEAPOLIS, MN 55419-1852
(612) 801-1268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12257
MN
Other
Enumeration date
05/21/2007
Last updated
01/06/2012
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