Organization
DUTCHMAN DENTAL LLC
Active
Other names
Jon-Paul Van Regenmorter
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON-PAUL VAN REGENMORTER DDS (OWNER)
(401) 624-9177
Entity
Organization
Contact information
Practice address
1359 MAIN RD, TIVERTON, RI 02878
(401) 624-9177
(401) 624-9233
Mailing address
1359 MAIN RD, TIVERTON, RI 02878
(401) 624-9177
(401) 624-9233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN2748
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0281077
—
MA
Enumeration date
09/26/2006
Last updated
08/22/2020
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