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General NPI Number Information
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NPI Number | 1134322183
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Entity Type | Individual
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Provider Name | TODD RONALD REGNAERT DMD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2816 VINE RD
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City | VINELAND
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State | NJ
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Zip | 08360-9225
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Country | US
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Telephone | 856-691-0168
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Fax |
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Provider Business Mailing Address
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Address Line | 2816 VINE RD
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City | VINELAND
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State | NJ
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Zip | 08360-9225
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Country | US
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Telephone | 856-691-0168
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN13910
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D102404700
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License Number State | NJ
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