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General NPI Number Information
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NPI Number | 1588668206
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Entity Type | Individual
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Provider Name | ANTHONY JOSEPH REGA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5401 NORRIS CANYON RD STE 210
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City | SAN RAMON
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State | CA
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Zip | 94583-5408
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Country | US
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Telephone | 925-830-0800
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Fax | 925-830-0871
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Provider Business Mailing Address
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Address Line | 5401 NORRIS CANYON RD STE 210
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City | SAN RAMON
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State | CA
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Zip | 94583-5408
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Country | US
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Telephone | 925-830-0800
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Fax | 925-830-0871
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 50977
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License Number State | CA
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