Provider Demographics
NPI:1023003845
Name:REGAS, MARAL FLORA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARAL
Middle Name:FLORA
Last Name:REGAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WARREN ST
Mailing Address - Street 2:UNIT 337
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-6456
Mailing Address - Country:US
Mailing Address - Phone:617-251-8577
Mailing Address - Fax:
Practice Address - Street 1:2417 MCGUIRE BLVD
Practice Address - Street 2:
Practice Address - City:MC GUIRE AFB
Practice Address - State:NJ
Practice Address - Zip Code:08641-5118
Practice Address - Country:US
Practice Address - Phone:609-754-3786
Practice Address - Fax:609-650-3786
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21119122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist