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General NPI Number Information
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NPI Number | 1831839414
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Entity Type | Individual
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Provider Name | COURTNEY TERESA REGAN DMD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 62 KIRKHAM ST
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City | BRANFORD
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State | CT
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Zip | 06405-3504
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Country | US
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Telephone | 203-488-6314
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Fax | 203-488-6315
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Provider Business Mailing Address
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Address Line | 1240 WHITNEY AVE
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City | HAMDEN
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State | CT
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Zip | 06517-2813
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Country | US
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Telephone | 203-287-0666
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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 | 13831
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License Number State | CT
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