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General NPI Number Information
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NPI Number | 1295902336
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Entity Type | Organization
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Legal Business Name | MICHAEL C. REGAN D.M.D. P.C.
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 6969 SE LAKE RD
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City | MILWAUKIE
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State | OR
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Zip | 97267-2103
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Country | US
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Telephone | 503-654-8283
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Fax | 503-659-5210
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Provider Business Mailing Address
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Address Line | 6969 SE LAKE RD
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City | MILWAUKIE
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State | OR
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Zip | 97267-2103
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Country | US
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Telephone | 503-654-8283
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Fax | 503-659-5210
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICHAEL C REGAN
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Credential |
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Telephone | 503-654-8283
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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 | 6536
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License Number State | OR
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