Provider Demographics
NPI:1518980010
Name:REGAN, STEVEN LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LEE
Last Name:REGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 S AVENUE T
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-1833
Mailing Address - Country:US
Mailing Address - Phone:254-675-8301
Mailing Address - Fax:254-675-6505
Practice Address - Street 1:102 S AVENUE T
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-1833
Practice Address - Country:US
Practice Address - Phone:254-675-8301
Practice Address - Fax:254-675-6505
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX188121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice