MEDICARE: JONATHAN A BREGMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4174	NC

General Provider Information

NPI Number	:	1770779753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN A BREGMAN

Provider Business Mailing Address
First Line	:	3913 STERLING RIDGE LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-5459
Country	:	US
Telephone Number	:	919-489-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3913 STERLING RIDGE LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-5459
Country	:	US
Telephone Number	:	919-489-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	09/24/2007

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Directions to “ JONATHAN A BREGMAN ” Practice Location

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