Individual
DR. REGAN MACKINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4920 SOUTH 30TH STREET, SUITE 103, OMAHA, NE 68107-1656
(402) 932-7204
(402) 952-1020
Mailing address
4920 SOUTH 30TH STREET, SUITE 103, OMAHA, NE 68107-1656
(402) 932-7204
(402) 952-1020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08412
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0494104
—
IA
Enumeration date
09/27/2006
Last updated
01/29/2016
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